Page 1

APPLICATION FORM
FORM.002/HR/ZIN

Please fill in with Block Letters

PRIVATE AND CONFIDENTIAL

Date 17 October Earliest starting date 1 November Notice required

Alternative position
Position applying for Waiterss

Current basic net salary Rp.3.600.000 Expected basic net salary Rp.4.000.000

Current other benefits BPJS & Services

Current working schedule

v 5 Days 6 Days

Current employment status

v 1 Year Contract 2 Years Contract Permanent

Personal Information
Name Ni Kadek Diva Saraswati
Gender Male v Female
Date of Birth 4 April 2003

Blood Type -

Race

Religion Hindhu

Marital Status Single

Number of Children & Age -

Driving License A B1 B2 C v

Own Vehicle None Bicycle v Motorcycle Car

v

Address
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APPLICATION FORM
FORM.002/HR/ZIN

Street Jl. Pulau Galang 1 Gang Batur No. 2 Number 082340058267

City Denpasar ZIP Code 80221

Telephone number - Driving time to work 1 Hour

Whatsapp number 082340058267 Fax number -

Email address Divasaraswati04@gmail.com

Skype - Others -

Employment Record
Please list the last 3 positions you have held, showing present / last position first.

Employer Sky Garden Bali (PT.Sky Garden Bali Indonesia)

Address of Employer Jl. Legian No 61X Kuta - Bali

Nature of Business Food and Beverage

Employed from 19 December 2022 Employed till 30 September 2023

Position & Duties Waiterss

Duites : Handle the guest, setup table, preparing menu

Reference Name Position Tell Number Email address

Mr. Samuel Bloxton General Manager 082123401907 -

Basic Net Rp.3.600.000 Reason for leaving Want to more experience in another company
Salary

Employer Legion Party Club Bali

Address of Employer Jl. Legian No 177, Kuta – Bali

Nature of Business Food and Beverage

Employed from 20 October 2022 Employed till 15 December 2022

Position & Duties Waiterss

Duites : Handle the guest, setup table, preparing menu
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APPLICATION FORM
FORM.002/HR/ZIN
Reference Name Position Tell Number Email address
- - - - -

Basic Net Rp. 3.000.000 Reason for leaving -

Salary

Employer

Address of Employer

Nature of Business
Employed from Employed till

Position & Duties

Reference Name Position Tell Number Email address

Basic Net Salary Reason for leaving

Other References
Preferable direct superior in your previous companies
Name Company Position Phone Number Email Address

Preopening Experience
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APPLICATION FORM
FORM.002/HR/ZIN
Do You have any pre-opening experience?
Yes No v

If yes, please specify

Bantu preparing setup venue

Education and Courses

From To Name school and address Degree / Certificate Major Course of Study

2022 STPB (Sekolah Tinggi Degree D1 Hospitality

2021
Perhotelan Bali)

Languages

Mother tongue

Spoken Written Understanding

Others
Fluent good notions Fluent good notions Fluent good notions
English v v v

Indonesia v v v

Computer Skills

Explain in brief your computer skills :

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APPLICATION FORM
FORM.002/HR/ZIN

Convictions
Do uou have any previous convictions? Yes v No

If yes, please specify

Medical History
Do you have any physical disability? Yes v No

If yes, please specify

Have you ever had any serious illness or Yes v No
accident?
If yes, please specify

How do you know about the vacancy ? JobStreet

Comments

Any further comments that might be of use to your application, please list here :
-

I hereby confirm that all information given is complete, accurate and true.
I authorize the verification of all information provided.
I understand that any incomplete or false statements might cause my immediate dismissal.

Date 17 October 2023

Signature _____________________