Professional Documents
Culture Documents
Please write the information legibly and in printed form. Put N/A if the needed information is not available.
Marital Status
Spouse’s Full Name :- Occupation :-
Number of Children :-
Member of Family
Full Name Relationship Occupation
Educational Background
School Year Graduated GPA Degree
Health Condition
Do you have any current serious sickness / previous surgery? _____Yes __х__No
If so, please specify : -
References (Must fill at least 2 person)
Name Title Company Email / Phone Number
Anindita Zahra Client Relationship Officer Lamudi Indonesia
Leader 089619202199
Client Relationship Officer
Putu Ari Pramesty Gold Lamudi Indonesia 081999076141
Declaration
I hereby certify that all information written here are true and correct to the best of my knowledge. In case of any of the
above information is found to be false or untrue or misleading or misrepresenting, I am aware that I may be held liable
for it and will withdraw my application at Venteny Indonesia.
____________________
Signature