TRAINEE APPLICATION FORM

PERSONAL DATA

Name Sucia Rahmayenti

Home Address Komplek Perumnas Guru Joroong Pasia Tiku

Do you live : With parents ( )

Rented house ( P )

Others ( )

Date of Birth: 25 February 2003 Age: 22 Place of Birth: Tiku

EDUCATION & PROFESSIONAL QUALIFICATION

FROM - TO NAME OF SCHOOL/COLLEGE

2007 - 2008 TK MUTIARA IBU

2009 - 2014 SDN 25 PASIR TIKU

2015 - 2018 MTSN 1 TANJUNG MUTIARA

2019 - 2021 SMAN 1 TANJUNG MUTIARA

2022 - Sekarang UNIVERSITAS NEGERI PADANG

MEMBERSHIP OF SOCIETIES

Computer proficient P Yes No Type:

LANGUAGES INDONESIA ENGLISH OTHERS (please mention)……….

SPOKEN P

WRITTEN P

When are you available of training: 5 January

CATION FORM

Sex : Woman

Tel.No. (off)

(Res) :

(HP) : 081267284010

Religion : Islam

STATE LEVEL ATTAINED MAJOR COURSE/SUBJECT

(state dates and position held)

OTHERS (please mention)……….

Period of training: 5 june

JOB TRAINING HISTORY

Date of training: Date Training Ended:

Company:
Company:s Address:

State nature of the business:

Name & designation of immediate supervisor:
Detailed description of duties/responsibilities:

Date of training: Date Training Ended:

Company:
Company:s Address:

State nature of the business:

Name & designation of immediate supervisor:
Detailed description of duties/responsibilities:

Date of training: Date Training Ended:

Company:
Company:s Address:

State nature of the business:

Name & designation of immediate supervisor:
Detailed description of duties/responsibilities:
FAMILY DETAILS
OCCUPATION
RELATIONSHIP NAME AGE ADDRESS
PRESENT/PAST

Father Rahman Rahim 53 Tiku PNS

Mother U Susanti 46 Tiku IRT

Fajriyal Syarif 23 Tiku Pelajar

Ariful Fikri 18 Tiku Pelajar

Brothers/ Sisters Daffa Alfarizi Hakim 12 Tiku Pelajar

Muhammad Gibran 9 Tiku Pelajar

MEDICAL DETAILS
Are you in a good health? Yes P No If no, why?

Please state with dates, any serious illness, allergies, operations, disabilities or accidents, you had:

P
Do you take alcohol/ drugs? Yes No To what extend?
P
Have you ever been convicted in a court of law? Yes No

if so, give details:

Hobbies, games & other interests

Membuat Kue

ADDITIONAL INFORMATION - Give any additional information which you consider may be of interest to a prospective

training, if possible state why you believe you are suitable to have the job training here

Magang disini adalah suatu kebanggaan bagi saya , karena saya akan banyak mendapatkan ilmu yang luas dan akan bisa saya praktek kan ilmu yang telah saya

dapat selama kuliah ini, karena minat bakat yang saya punya dan pendidikan serta membuat saya yakin bahwasanya saya bisa berdidikasi untuk perusahaan ini

I HEREBY CONFIRM ALL THE ABOVE DETAILS TO BE TRUE AND CORRECT.

Date: 15 Desember 2023 Signature:

u yang telah saya

uk perusahaan ini
Compatibility Report for excel sucia rahmayenti.xls
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