F-SHIMS-HRD-P01.

3/0/22-12-06

CONFIDENTIAL
SHIMIZU CORPORATION

(Date)
Interview I :
Photo Interview II :
Running Test :

1. CURRICULUM VITAE

Name : Date of Birth :

Home Address : Place of Birth :
Status :
Home/HP number : Religion :
Office Address : Other Language Skills :
Email :
Telephone :

2. FORMAL EDUCATION

Year Name of School/Academy/Univ Faculty Diploma/Certificate

3. COURSE/SEMINAR etc.

Year Field/Kind of Performer Place Certificate

4. EXPERIENCE

Name & Line of Company's Direct

Period of Work Position Salary
Business Manager
ORGANIZATION CHART (which is shown your position in your latest office)

In each position

Position Details of Work (Duties, Responsibility etc) Reason for resign

Expected Salary Other Facilities Vehicle

Bonus Annual Leave Etc.

REFERENCE

Name Company Position Address & Phone

ORGANIZATION/CLUB MEMBERSHIP (Student/Social in past or present time)

Year Name of Organization/Club Position Place

HOBBY AND ACTIVITY

Hobby :

Reading Acitvity * Banyak

A lot Subject you read :
** Enough
* Enough
** A little
* A Little
Newspapers/Magazine you read:
Newspapers:
Magazines :

FAMILY'S STRUCTURE

Relationship Name Gender Latest Education/Work

Father
Mother
1st bros/sis
2nd bros/sis
3rd bros/sis
4th bros/sis
5th bros/sis

Wife/Husband
1st child
2nd child
3rd child
4th child

EMERGENCY CONTACT NUMBER (Family who do not leave at the same house)

Name Fraternal Relations Phone No. Address

I confirm that all information above are correct to the best my knowledge

…………………………………………,
Applicant

(…………………..)