PHOTO

APPLICATION FORM

Name : Rahmad Hardianto

ID Card No : 7472022512790003 ,

Current Home Address : Jl. Wijaya Kusuma 23 Cibinong, Bogor

Jawa Barat 16914
Sex : o Female √ Male
Telp. Np. Office : HP : 0812 8597 8971
Residence : Email : :
ra.hardia@yahoo.com
Emergency Contact : 0813 8329 9090
Date of Birth : Dec. 25, 1979 Age : 43
Place of Birth : Wanci (Wakatobi)
Marital Status : Married, has 3 children Nationality :Indonesia
Race : Sulawesi Religion: Islam
Driving License : 79122440490 (A) Do you own a car : o Yes √ No

EDUCATION & PROFESSIONAL QUALIFICATION

FROM - TO STATE LEVEL ATTAINED MAJOR COURSE OR
NAME OF SCHOOL, COLLEGE
(STATE DATE) SUBJECT

2009 - not continued Universitas Indonesia (Jakarta) Master program in Geophysical Reservoar
1999 - 2007 Universitas Padjadjaran (Bandung) Geological Engineeriing study program
2003 - 2007 Institut Teknologi Bandung Geological Engineeriing study program

CURRENT REMUNERATIONS (In Rupiah)

CURRENT EXPECTED

Basic :
alowance :
alowance :
Facilities : Transportation, mess, meal, laundry Transportation, mess, meal, laundry
Incentive (month/quarter) : As per standards As per standards
Bonus (if any) : Target or production bonuses Target or production bonuses
Medical : As per standards As per standards
others :
Take Home Pay : Rp. 25.000.000 More than Rp 25.000.000 (at least the same)

PREFERENCES
Notice day of Interview : 2 or 3 days
Availability to join : As soon as possible month (s) notice

EMPLOYEMENT HISTORY (Commence with current or last employment)

Date of Employment : Jan. 2021
Date Employment Ended : On going
Name of Company : PT. Inti Aset Bumi
Address of Company : Main office in Kendari, Southeast Sulawesi
:
Company nature business/product : Mining
Position Held : Project Manager
Direct Supervise by (position) : Director (the owner)
Total of employee in company : In a normal situation, about 50 people
Direct subordinates : All divisions and employees
Give details description of duties/responsibilities : Please see in my Curriculum Vitae

How did you get employed in this company : Based on a recommendation from my colleague
(Through Advertisement, Recommendation, etc)
Reason for Leaving : I am still joining this company
Last Drawn Salary : Still the same as when I entered

Date of Employment : Apr. 2015

Date Employment Ended : Dec. 2020
Name of Company : Some mining companies (please see in my Curriculum Vitae)
Address of Company : Some sites or work locations
(Please see in my Curriculum Vitae)
Company nature business/product : Nickel Mining
Position Held : Consultant Geologist
Direct Supervise by (position) : Director (the owner), Project Manager
Total of employee in company : About 200 employees
Direct subordinates : Geologists and mining engineers
Give details description of duties/responsibilities : Please see in my Curriculum Vitae

How did you get employed in this company : Based on a recommendation from my colleague
(Through Advertisement, Recommendation, etc)

Reason for Leaving : Projects and contracts completed

Last Drawn Salary : The same as the agreement at the beginning

Date of Employment : May 2012

.

Date Employment Ended : Mar. 2015

Name of Company : PT. PAM Mineral & PAM Group
Address of Company : Main office in Jakarta
:
Company nature business/product : Mining (nickel, coal, manganese, and other interest)
Position Held : Senior Geologist
Direct Supervise by (position) : Project Manager
Total of employee in company : About 200 employees, depending on work location
Direct subordinates : Mining & Exploration Geologists, Grade Controllers, Drillers
Give details description of duties/responsibilities : Please see in my Curriculum Vitae

How did you get employed in this company : Based on a recommendation from my colleague
(Through Advertisement, Recommendation, etc) :
Reason for Leaving : Resigned for personal reasons
Last Drawn Salary : As I should have received

FAMILY DETAILS
OCCUPATIO
NAME OF
RELATIONSHIP NAME ADDRESS AGE N PRESENT
EMPLOYER
/PAST
Father Laode Onda Almarhum Almarhum

Mother Waode Hasinah Almarhum Almarhum

Brother/sister Takdir A. Bau-Bau 50 Director A private bank

Ridwan A Almarhum Almarhum

Nining K Kendari 46 Housewife

Spouse Risma Y Bogor 41 Housewife

Children Abdullah S A Bogor 10 Student
Abdillah S B Bogor 8 Student
Abdallah S R Bogor 6 Student

LANGUAGES

LANGUAGES
INDONESIA ENGLISH CHINESE (SPECIFY) JAPANESEDDDDDD..DDDDDD..
SPOKEN √ √ o o o o
WRITTEN √ √ o o o o

HOBBIES,GAME & OTHER INTERESTS

Reading, swimming, travelling

ADDITIONAL INFORMATION - Give any additional information which you consider may be of interest to a prospective employer
, if possible state why you believe you are suitable for the position you are applying
My complete education, skills, and work experiences, especially in nickel mining, are more than enough to
take charge well of this position, achieve targets and move the company forward

ORGANIZATION CHART OF COMPANY MOST RELEVANT TO POSITION APPLIED FOR.

(previous or current employer)
State name of company, indicate where you fit in within the organization.
EMPLOYEMENT REFERENCES (Ex Direct Superior from past employment)
NAME : Nara Nilandaroe, Ir., M.Sc.
POSITION : General Manager
COMPANY NAME : Genting oil & gas
COMPANY ADDRESS : Jakarta

TELP (OFFICE)/HP :

NAME : Prof. Benyamin Sapiie

POSITION : Senior lecturer, geological advisor
COMPANY NAME : PT LAPI Institut Teknologi Bandung
COMPANY ADDRESS : Bandung

TELP (OFFICE)/HP :

PERSONAL REFERENCES (Give names or person of responsibility who have known you for at least 3 years)
NAME : Asrim Kadir, ST, M.Sc.
POSITION : Researcher, senior lecturer
COMPANY NAME : Univ. Dayanu Ikhsanuddin
COMPANY ADDRESS : Bau-Bau

TELP (OFFICE)/HP :
HANDPHONE :
YEARS OF ACQUAITANCE
:

NAME :
POSITION :
COMPANY NAME :
COMPANY ADDRESS :

TELP (OFFICE)/HP :
HANDPHONE :
YEARS OF ACQUAITANCE
:

NAME OF COMPANIES WITH WHICH YOU HAVE PENDING APPLICATION FOR EMPLOYMENT
(Give dates of application)
1.
2.
3.

HAVE YOU APPLIED WITH THIS OFFICE BEFORE? o YES √ NO STATE DATE :
FOR CONSULTANT'S USE ONLY
Indicate your impressions gained from interviewing the applicant by making an (x) on the scale of each heading

FOR CONSULTANT'S USE ONLY

1. Appearance
o Very Untidy o Somewhat careless o Satisfactory Personal o Neat and tidy better o Unsually well
about personal appearance than average groomed and very
appearance appearance neat
2. Friendliness
o Appears very distant o Approachable; fairy o Warm, friendly; o Very Sociable and o Extremely
and aloof friendly sociable outgoing friendly; very warm
and outgoing
3. Poise
o At ease; jumpy o Somewhat tense; o Reasonable o Sure of himself/ o Extremely well
and very nervous easily irritated at ease herself composed
4. Personality
o Unsatisfactory o Doubtful o Average and o Very good; above; o Outstanding
satisfactory average excellent all
around
5. Conversational Ability
o Talks very little; o Tries to express o Average fluency and o Talks well and does o Excellent expression
expresses himself/herself clearly expression not waste words extremely fluent;
poorly forceful
6.Alertness
o Very slow to grap o Rather slow requires oGrasp ideas with o Quick to understand o Exceptionally alert
ideas more than average average speed perceives well understands new
explanation ideas instantly
7.Knowledge
o Poor, no appropriate o Limited knowledge o Average knowledge o Well informed; o Excellent knowledge
knowledge at all covering some areas not covering all knowledge covers with faultless
areas fully most areas coverage
8.Qualifications
o Not relevant to job o Some relevant to o Satisfactory; as o Very suitable o Ideal for job;
job good as might be for job perfect match
expected
9. Skill
o None approriate o Some skill in job o Reasonable o Well skill in job o Excellent skill and
area amount; average area ideal for job
for job
10. Experience
o No relation between o Some experience o Average; o Very good and o Excellent and
background and job in relevant area background cover relevant experience ideal background
job area
11. Drive and Initiative
o Poorly defined goals; o Make little effort o Average effort; o High desire to o Sets high goals;
acts without purpose to achieve goals some initiative achieve; strives hard always takes initiative

CONSULTANT RECOMMENDATION
Dressing and Appearance :
Language Ability/Voice :
Other Information/Comments :
Day/date Consultant's Signature

I HEREBY CONFIRM ALL THE ABOVE DETAILS TO BE TRUE AND CORRECT. I AUTHORISE PT. PERSOLKELLY Recruitment INDONESIA TO CARRY
OUT REFERENCE CHECKS WITH PAST EMPLOYERS AND REFEREES IN CONNECTION WITH THIS APPLICATION AND I AGREED TO GIVE MY LATEST
COPY OF SALARY SLIP FROM MY CURRENT EMPLOYER FOR THIS APPLICATION WHEN REQUIRED.

I HEREBY CONSENT TO PT. PERSOLKELLY Recruitment INDONESIA AND ITS AFFILIATES COLLECTING, USING AND DISCLOSING MY PERSONAL
DATA TO PROSPECTIVE EMPLOYERS TO COLLECT USE AND DISCLOSE THESE PERSONAL DATA FOR PURPOSES OF EVALUATING MY
SUITABILITY FOR EMPLOYEMENT. I ACKNOWLEDGE THAT THE FULL PRIVACY POLICY IS AVAILBLE AT www.persolkelly.co.id OR AT MY REQUEST

I ALSO AGREE NOT TO SEEK OR ACCEPT EMPLOYMENT EITHER DIRECTLY OR INDIRECTLY FROM ANY CLIENT PT. PERSOLKELLY Recruitment
INDONESIA TO WHOM I HAVE BEEN SENT FOR AN INTERVIEW, FOR AT LEAST THREE MONTHS AFTER DATE OF INTERVIEW.

I UNDERSTAND THAT ANY MISREPRESENTATION OR OMISSION OF INFORMATION WILL BE SUFFICIENT REASON FOR WITHDRAWAL OF AN OFFER
OR SUBSEQUENT DISMISSAL, IF EMPLOYED.
Saya menyatakan bahwa semua informasi yang saya berikan di sini adalah benar. Saya memberikan wewenang kepada PT. PERSOLKELLY Recruitment
INDONESIA untuk melakukan cek referensi kepegawaian dari perusahaan tempat saya bekerja sebelumnya dan kepada pihak yang berhubungan dengan
aplikasi ini. Saya setuju untuk memberikan salinan dari slip gaji terakhir dari perusahaan tempat saya bekerja saat proses wawancara berjalan ketika
dibutuhkan.
Saya dengan ini mengizinkan PT. PERSOLKELLY Recruitment Indonesia dan afiliasinya mengumpulkan, menggunakan dan mengungkapkan data pribadi
saya kepada calon Pemberi Kerja untuk mengumpulkan, menggunakan dan mengungkapkan data pribadi ini untuk tujuan mengevaluasi kesesuaian saya untuk
pekerjaan. Saya juga mengakui bahwa Kebijakan privasi lengkap tersedia di www.persolkelly.co.id atau atas permintaan saya.

Saya juga setuju untuk tidak melamar atau menerima tawaran kerja baik secara langsung ataupun tidak langsung dari klien PT. PERSOLKELLY Recruitment
Indonesia, kepada siapa saya telah diproses untuk interview, sedikitnya 3 (tiga) bulan setelah tanggal interview.
Saya memahami bahwa apabila ditemukan ketidakbenaran dalam informasi yang saya berikan, maka hal tersebut dapat menjadi alasan yang cukup untuk
penarikan dari proses rekrutment yang sedang berlangsung atau pembatalan bagi surat perjanjian kerja, bilamana sudah ditandatangani.

Monday / Feb. 27, 2023 Rahmad Hardianto

Day/date Signature