APPLICANT DATA FORM

Please fill in below data in English, and please circle “0” your choice if required.

Date : / /20

Applied Position :

Full Name :

ID Type : KTP/SIM/PASSPORT/OTHER

ID Number :

Place / Date of Birth :

Sex : Male / Female

Blood Type : A / B / AB / O

Home :

Phone / Hp Number :

Email Address :

Religion :

Marital Status : Single / Married / Divorced, With Number of children (s)

Nationality : Indonesia / Other

CENTRIN-AFATEC
Komplek REDTOP Hotel Blok D-9 | Jl. Pecenongan No. 72 | Jakarta 10120
Phone : +62-21 3890-1188| Fax: +62-21-3890-1177
FAMILY MEMBER (Please fill in from the head of the family or from the eldest)

No Name Relation Age Sex Formal Education Job / Activity

6
Relation : Parent, Parent in-law, Brother, Sister, Spouse, Children, Etc.
Sex : M / F (Male / Female)
Formal Education : High School, Bachelor Degree, Master Degree, Doctor Degree, Etc.
Job / Activity : Private Employee, Government Employee, Home Maker, Etc.

FORMAL EDUCATION (Please fill in from highest level of education down to senior high school)

No Education Institute Name Start Graduated Major / Subject Education Level

Year Year

6
Major / Subject : Marketing, Accounting, Information Technique, etc.
Educational Level : Senior High School, Diploma, Bachelor / S1, Master /S2, Doctor /S3, Etc.

CENTRIN-AFATEC
Komplek REDTOP Hotel Blok D-9 | Jl. Pecenongan No. 72 | Jakarta 10120
Phone : +62-21 3890-1188| Fax: +62-21-3890-1177
NON FORMAL EDUCATION (Please fill in from the latest)

No Education Institute Name Start Graduated Major / Subject Certification (Yes/No)

Year Year

Major / Subject : Networking, Database, Table Manner, Tax Brevet A-B-C, Etc.

Social Media Information

No Social Media Username

CENTRIN-AFATEC
Komplek REDTOP Hotel Blok D-9 | Jl. Pecenongan No. 72 | Jakarta 10120
Phone : +62-21 3890-1188| Fax: +62-21-3890-1177
LANGUAGE PROFICIENCY (Excluding Bahasa Indonesia)

Please fill in with number to describe your level from 1 (lowest) to 10 (highest)

No Language Writing Listening Speaking

WORKING EXPERIENCE (Please fill in from the latest one)

1 Company Name
Address
Business / Industry
Phone
Latest Position
Brief Job Description

Report to Mr. / Mrs. / Ms.

Position:
Phone Number:
Latest Salary
Other Benefit
Starting Date Date / Month / Year
Exit Date Date / Month / Year
Reason to Leave

CENTRIN-AFATEC
Komplek REDTOP Hotel Blok D-9 | Jl. Pecenongan No. 72 | Jakarta 10120
Phone : +62-21 3890-1188| Fax: +62-21-3890-1177
2 Company Name
Address
Business / Industry
Phone
Latest Position
Brief Job Description

Report to Mr. / Mrs. / Ms.

Position:
Phone Number:
Latest Salary
Other Benefit
Starting Date Date / Month / Year
Exit Date Date / Month / Year
Reason to Leave

3 Company Name
Address
Business / Industry
Phone
Latest Position
Brief Job Description

Report to Mr. / Mrs. / Ms.

Position:
Phone Number:
Latest Salary
Other Benefit
Starting Date Date / Month / Year
Exit Date Date / Month / Year
Reason to Leave

CENTRIN-AFATEC
Komplek REDTOP Hotel Blok D-9 | Jl. Pecenongan No. 72 | Jakarta 10120
Phone : +62-21 3890-1188| Fax: +62-21-3890-1177
4 Company Name
Address
Business / Industry
Phone
Latest Position
Brief Job Description

Report to Mr. / Mrs. / Ms.

Position:
Phone Number:
Latest Salary
Other Benefit
Starting Date Date / Month / Year
Exit Date Date / Month / Year
Reason to Leave

OTHER INFORMATION

1. What do you think as your greatest achievements & failures made as professional or personal?
My greatest achievement was finish my college on time, complete each course for each semester
with good grades and my failures was failed to enter state university so I had to look for a private
scholarship.
2. What is the most sensitive issue that you are not willing to discuss?
Personal, religion and politic.

3. What are your most notable strengths & weaknesses? Please Explain
My most notable strength is I’m focused, fast learner, pay attention to
details and my notable weaknesses is that I need more experience and
confidence.
4. Can you tell us about your ability to work under pressure? Please Explain
Always calm and focused when I have to work under pressure.

CENTRIN-AFATEC
Komplek REDTOP Hotel Blok D-9 | Jl. Pecenongan No. 72 | Jakarta 10120
Phone : +62-21 3890-1188| Fax: +62-21-3890-1177
5. Have you ever loose your interest (work,study, or hobby? Why?
I have never loose my interest

6. What do people most often criticize about you?

Overthinking about what people think about me.

7. If the people who know you were asked why you should be hired, what would they say?
They would say I'm a hard worker and fascinated to learn something new.

8. Describe a time when your workload was heavy and how you handled it!

Can you tell us about your hopes and dreams for the future? What do you do to achieve
9. your hopes & dreams?
Happiness for me, my parents and family. By studying and striving hard.

10. What are Your hobbies? Does it affect your work?

Travelling, would not affect my work since I only travel on leave days.

11. Tell me about how confident you are in related to your capabilities?
I am highly confident to my abilities.

12. Tell me about a situation when your job went through big changes. How did you adjust?
By adapting to every changes.

13. Have you ever experienced a terrible occurrence that has impacted you significantly? Examples
may include being the victim of armed assault, witnessing a tragedy happen to someone else,
surviving a sexual assault, or living through a natural disaster, childhood trauma?
I've never experienced those myself.

14. Tell me about any important activities or projects that you’ve been involved with recently. How
much enjoyment do you get from these?
Take part to my sister online business. I love the experience I got.

15. If you could change one thing about your personality, what would it be and why?
Confidence. It's not that I'm not confident, but I want to be much more confident.

CENTRIN-AFATEC
Komplek REDTOP Hotel Blok D-9 | Jl. Pecenongan No. 72 | Jakarta 10120
Phone : +62-21 3890-1188| Fax: +62-21-3890-1177
 16. What do You know about our company?
Technology companies.

17. Why do You choose to join with us?

I believe I would learn a lot of things at Centrin Afatec.

18. Why do You think You are the best candidate for this position?
I believe I'm the best candidate for this Accounting / Finance Staff position because it's
suitable to my education and passion.

19. Describe your competitiveness and rate your survical spirit (one out of ten)!
Competitiveness: 9
Survival Spirit: 10

20. What is Your expected Salary & expected benefit/allowances other than salary?
5.5 million IDR and BPJS.

21. When is the earliest date that can You start working with us?
As soon as possible.

22. Do You have Vacation I Wedding Plans for the next 1year?
No, I wouldn't.

23. What criteria will You consider as the most important for accepting this job?
Detail-oriented, communication and fast learner.

24. Did You apply or currently in progress of recruitment process with other company: YES /
NO
Yes.

25. How likely is for You to accept our company's job offer if You receive other job offers?

26. I would love to join Centrin Afatec.

We will contact with your previous company. Please fill out the column on pages 4 to 6 with your
company's phone number.

Thank You for Your time filling in the applicant form, we will let You know if You are shortlisted.
hereby certify that the data I write in this applicant form is true, and if it found false in the future, I am
willing to accept any penalties or disciplinary actions and will not hold back to the company
CENTRIN-AFATEC
Komplek REDTOP Hotel Blok D-9 | Jl. Pecenongan No. 72 | Jakarta 10120