EMPLOYMENT APPLICATION FORM
ADVICE This application will be kept strictly confidential; thus, please fill in complete information.
Put N/A where it's not applicable; if you write in English, please use capital letters. Photograph
Position Applied for : Engineering Supervisior Expected Salary Only Rp. 5.000.000
Your heard of this position from Internet
PERSONAL DATA
Name : Mr./Mrs./Ms. Natanael Tatengkeng Surname Nathan
Present Address Lingkungan II, Kel.Pandu, Kec.Bunaken Darat Kota Manado
Tel. 081242688482
E-mail address [email protected] Age 35 Years Height 168 cms. Weight 58 kgs.
Date of Birth 03 September 1985 Place of Birth Manado
Nationality Indonesia Religion Kristen Protestan
ID. Card No./Passport No. 7171080309850001
Issued by Expiry Date Lifetime
Marital Status Single Married Separated Widowed Divorced
Spouse's Name Elfira Mundaeng Age 33 Occupation / Firm Ibu Rumah Tangga
Address / Tel. Lingkungan II, Kel.Pandu, Kec.Bunaken Darat Kota Manado
Number of Independenys: 2
Please give Name, Age, Sex of each. Natasya Imanuella Tatengkeng 14 years Female
Josua Engelbert Tatengkeng 10 years Male
FAMILY PARTICULARS
Father's Name Taka Tatengkeng Age Occupation
Mother's Name Melfa Datunsolang Age Occupation
Number of Brothers (ชาย) 2 Brother Billy Tatengkeng
EDUCATION RECORD
Educational Level Name and Address of School/College From-To-Year Certificate Major
Primary SDN 18 jakarta selatan 1998
Secondary SLTP N 9 manado 2001
Vocational SMK EL FATAH Manado [elektronika komunikasi] 2004
University
Others
MAJOR TRAINING COURSES OR SEMINAR ATTENDED
Course/Topic Institute of Organizer Date of Training Certificate Obtained
PROFICIENCY IN LANGUAGE
Please tick "√" where applicable.
Speak Read Write
Languages
Good Fair Poor Good Fair Poor Good Fair Poor
English
French
Japanese
indonesia
OTHER SKILLS
Typing Chinese wpm English wpm Fax Operation
Computer Program : Word Excel Power Point Pagemaker Other…………..
EMPLOYMENT RECORD
Please list all employments, starting with present or most recent job.
Employment Date
Company's Name and Address Position Held Final Salary Reason for leaving
From To
Jan 2007 - Okt 2007 CV.Karya Teknik Teknisi
Jan 2008 - Okt 2008 Amara Bela Internasional Hotel Ternate Staff Engineering
May 2009 - Okt 2012 Aston Manado Hotel Staff Engineering
Nov 2012 - Juli 2014 CV.A L Manadiri Senior Engineering
July 2014 - Mar 2015 Cantika Swara Resort Berau Senior SPV Engineering
Jan 2016 - Jan 2017 Best Western The Lagoon Manado Engineering General Maintenance
Mar 2017 - Now Four Point By Sheraton Manado Senior Engineering General Maintanace
Can we contact your employer (s)? Yes No
Are you self employed? Yes No
HEALTH
Have you had any serious illness or injury durin the past 5 years? Yes No
If YES, please describe :
Do you have any physical handicaps, chronic diseases, or other disabilities? Yes No
If YES, please describe :
MISCELLANEOUS
Ability to drive a vehicle Car Motobike Other
Driving license (if any) : Type of vehicle
Kind Yearly Permanent License No.
Your interest in social and recreational activities
Club or association you are a member of
1 2 3 4
Your hobbies : otomotif modifikasion
Have you joined the military service? Yes No Exempted
Have you ever charged or convicted of any criminal offence against the law?
Yes No If YES, describe Date, Charge, and Verdict.
Nature of Offence
Please list relatives or friends currently employed in this Company (if any).
Name Position Relationship
1 Jefrry Tumbelaka Chief Engineering
2 Geston Amarala Human Resources Manager
Person to contact in case of emergency :
Name elfira debora mundaeng Relationship
Address pandu lingkungan II kecamatan bunaken kota manado Tel. ###
Persons of Reference (Not a relative; former supervisors are preferable)
Name Work Place Position
1 jefrry tumbelaka engineering independent chief engineering
2 geston amarala four point sheraton manado heman resousces manager
If you are accepted, what is your notice period 30 days after being accepted Days
I certify that all information given in this application is true and complete to to the best of my knowledge. I understand that wilful misrepresentation,
false statements or omission of facts will be adequate ground for dismissal.
Applicant's Signature natanael tatengkeng Date 07 oktober 2019
INTERVIEW ASSESSMENT
PART 1 : INTERVIEW BY HR DEPARTMENT
Descriptions Excellent Good Fair Poor Remarks
1 Personal & Appearance
2 English skills
3 Academic Achievement
4 Occupational Experience
5 Atitude
6 Initiative
7 Self Confidence
Overall Comment
Result To Div./Dept. Head for Final Interview To Keep in waiting list To regret
Position applied for Department
Interviewer Date
PART 2 : INTERVIEW BY DEPT. AND/OR DIV. HEADS CONCERNED
Descriptions Excellent Good Fair Poor Remarks
1 Skills/Job Related Experience
2 Education
3 Communication Skills
4 Attitude
5 Quality Customer Service Skills
6 Self - Confidence
7 Appearance
8 Suitability For This Position
Comment
To hire To keep on file To regret
Dept. Head's Signature Date
Div. Head's Signature Date
PART 3 : TO BE COMPLETED BY HUMAN RESOURCES DEPARTMENT
Position Level Salary Date of Employment
Mgr./Dir. Of Human Resources Date
PART 4 : TO BE ACKNOWLEDGE BY EAM / GM
Executive Assistant Manager / General Manger Date
