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  • Form Aplication

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    Hanry WR
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    17 views7 pages

    Form Aplication

    Uploaded by

    Hanry WR
    app form

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
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    of 7
    MBG PT MAJU BERSAMA GEMILANG FORM APLII SEES ea ca nce 2 ese Test aot ee KAS! KANDIDAT KARYAWAN Application Form fIsilah Form ini dengan Jengkap dan data yang benar.Isilah dengan huruf balok. Please ill the form completely with valid data & use the copital! Nama Lengkap (Fut! Name) HANRY WIRANATA REPPI Tempat / Tel & thn Lair TANGERANG, 22.03-1904 (Place & Date of Beh) Atamat sekarang & Kode Pos Rava Wo 19 LT C200 KEL PETUMANIGAN SELATAN, REC (Permanent Address) FPESANGGRAHAN, JAKARTA SELATAN, DKI JAKARTA 12270 Telepon & HP (Phone) logss-4651-7622 ‘Alamat E-mail {E-mail Address) nanrymwanatagpgmsil som ‘Alamat Tinggal Orang Tu3& Kode Pos PERUMAHAN TAMAN CIBODAS, JLTERATAI3 Golongan Darah (Blood Type) [Porents Permanent Address) KOTA TANGERAG -BANTEM 15126 ‘Agama (Religion) KRISTEN PROTESTAN No KTP/SIM/Passport 7 umbey [357 1072202840008 Kewarganegaraan (Nationality) NOONESIA Status Pernitahan (Marital Status! | MENIKAH A Hobby/Minat (Hobby) BERMAIN BASKET, MEMANCING, CAMPING ,BACA BUKU Akun Sosial Media (S00 ‘account) Media LINKEDINIG/FB : HANRY WIRANATA REPPI MBG PT MAJU BERSAMA GEMILANG DATA KELUARGA [ FAMILY DATA} Data tanggungan { Suamifist ‘sudah menikah] / Dependent Data) Hubungan Kelvanga wamaitame) Up | ,Tempat/Teltatir | Pendiditan | Pekeriaan (Relationship) (Name) (Place/Date of Birth) | (Education) | (Occupation) Gaome/ Ist (Spoure) | ARTNITRWIVANT | |wonoomianasaor| er esenances] Anakke i(Ghiléren 3) ‘Anak ke 2 (Children 2) “Anakke 3 |Childven 3) “Anakke 4 (Children 4) ‘Rnakke 5 (Children 5) ‘Anggota keluarga yang dapat dihubungi dalam keadaan darurat (Emergency Information Data} : Nama {Name} Alamat (Adress) Telp (Phone Num :ARIAN TRIWIVANTL Hubungan (Relationship) ISTRI -APARTEMENT GATEWAY PESANGGRAMAN,JL CILEDUGRAYA No 15. LT 5. “C5-06.KELPETUKANGAN SELATAN, KEC. PESANGGRAHAN, JAKARTA SELATAN, DKI SRKARTA 12270 ‘OBIS 1401-5256, ‘Susunan keluarga , termasuk Anda { please describe your family member include yourself } ubungan Keluzrga Nama/No.Telp. | up | Tempel Teltanir | Pendidikan ] | Pekeriaan (Relationship) (anasTeip Neri) (Plsce/Dateot Birth) | (Education) | (Oceupoticn) “Ayah (Father) FOU oe Lo fravceranczocstert | cma | winausana (Mother | “EANSYE CORRYREPPU | > laanaposoo:sor:| ama | BU RUMAH te ner) OB57_14 18-3717. TE, Trak tandung eT HANRY WRT VAILAELE TO] (siblings number 1) 0a58-46517622 fravseranczzcztos4 | St KS Anak kandung he? ALFARDTW. AT ings nunber 2) 08128503 8549 1 [rawceranc.zaaez0m | SMA | KARYAWAN ‘Anak kandung ke3 (sibuings number 3) Anak kandung ke (Siblings number 8) Anak kandung keS (siblings number 5) MBG ° PT MAJU BERSAMA GEMILANG Sebutkan nama 3 anggota keluarga dan 2 teman anda yang dapat kami hubungi (Please mention Name 3 of family members and 2 of your friends that we can contact) Telepon Hubungan a Keterangan u Pekerjaan (ia | Navatiemey |p| AlamseiAasess) | orone, | (alton | Reluswet | arian TaIivanmi | F [JAKARTA forsorssse] arms —faursenameen Kuss ARIS t [Puworeso —— [osesesen] wakacipan | WIRAUSAMA eluarea Bu AUMAR maa) |__NANIEK P [FuRmoRev0 — [sasrerem| Kakacirar | BURUM Teman 1 JSALES ENGINEER] Temont[_ananomru | [aanarta eorseraseo | TEMAN Taman? Tareas) | surewono | | ancanra Se RIWAVAT PENDIDIKAN / EDUCATIONAL BACKGROUND TTenjang Pendidikan | Nama Sekolah Kola Periods. TorusanpPeringkat Nia) (level of Education }| (Institution) (City) (period) (Major) _|[Gracie) (Score) st puratRBERETAtavacd cweGoN | Tgorzors {| 7 SLEXTRO|322 = Ursikan secara singkat dan jelss mengapa Anda memilih jurusan tersebut ( Please describe why:do choose your major) Karena, saya tertarik akan technologi dimana jurusan T. elektro ilmunya akan terpakai baik dibidang lstrk tolekomunikast robotk.dan industri lainya Dan saya ingin turut serta dalam peckembangan technologi di Indonesia dan berkontribusi terhadap Negeri ink. = Jelaskan karya ilmish yang pernah Anda bust ( skripsi, artikel, karya tulis, dl) (Please describe ane of the thesis, article, essay, etc) Panelitan saya 2thn, dimana hasil karya ilmiah saya

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