PT KERAMIKA INDONESIA ASSOSIASI Tbk
Gd. Cowell Tower / Graha Atrium Lt.2 JOB APPLICATION FORM
Jl. Senen Raya No.135 Jakarta 10410
Tlp. (021) 350 6227, Fax (021) 386 2374 HRD Department
Fill this job application form clearly, complete and detail specified.
All the questions must be filled correctly, if someday proven that the data is incorrect, then you
considered
giving fake information or information that has been forged and this process considered to be cancel.
Fill by hand writing and using capital letters Pas Photo
Enclosed one Pas Photo with size 3X4 3x4
If you have questions in filling this form, asked the recruiter.
1. POSITION APPLIED
Position : _____________________________________________________________________________
2. PERSONAL DATA
Full Name : _____________________________________________________________________________
Sex : Male / Female *) (striketrough the unnecessary)
Date of Birth : ___________________________________ Place ____________________________________
Child : Only child / First / Second / Third / ______ *) (striketrough the unnecessary) from ____ siblings
Religion : ___________________________________ Nation ___________________________________
Height : _______________________________ Cm Weight: _______________________________ Kg
Last Education : Senior High School / Academy / University / Post Graduate *) (striketrough the unnecessary)
Maritial Status : Single / Married / Widower / Widow *) (striketrough the unnecessary)
Child Dependent : _______________________________________________________________________ person
Blood Type : _____________________________________________________________________________
ID Card Number : _____________________________________________________________________________
NPWP Number : _____________________________________________________________________________
Driving Lisence : C / A / B I / B II (striketrough the unnecessary) Driving Lisence No. : ________________________
Current Address : _____________________________________________________________ ________________
_____________________________________________________________________________
Telephone : Home ______________________________ HP. _____________________________________
E-Mail Address : ______________________________________________________________________________
In case of emergency, family, address, phone number that can be contacted:
Name : ___________________________ Family Relation: ___________________________________
Job : _____________________________________________________________________________
Current Address : _____________________________________________________________________________
_____________________________________________________________________________
Telephone : Home _______________________________ HP. ______________________________________
3. LATEST EDUCATION
Year
Education Level Name and the place of the school Major
Start Graduate
4. WORKING EXPERIENCE
Time of work (year)
Name of the company Position Last Salary Review Reason for Leaving
from untill
5. LANGUAGE SKILL
Language Reading Writing Speaking
1. English
2.
6. PARENTS
NAME AGE EDUCATION JOB
1.
2.
7. SIBLING (Include You)
NAME AGE EDUCATION JOB
1.
2.
3.
4.
5.
8. FAMILY LIST (Please Fill In If You Are Married)
NAME AGE EDUCATION JOB
Husband/Wife
1st Child
2nd Child
3rd Child
4th Child
9. STRENGTH AND WEAKNESS (Personality)
STRENGTH WEAKNESS
1.
2.
3.
1. Are you at the moment still working : Yes / No *) (striketrough the unnecessary) Where: ___________________
2. Remuneration package expected : ________________________________________________________________
3. When you are available to work : ________________________________________________________________
4. Do you able to be placed in our plant : Yes / No *) (striketrough the unnecessary)
5. Do you have relatives who works here : Yes / No *) (striketrough the unnecessary) Name: ___________________
Here with I declare that all the data I have written above is true and accurate, if the data proved not true or fake, can cause my
application to be rejected or if I have worked can be terminated right away.
Conclusion:
Jakarta, _________________________
1. Processed
2. Not Processed
Comments and reason:
__________________________________________________
___________________________________________________
___________________________________________________
________________________________
Applicant’s Signature
Date, _____________________________________________
(Recruiter)
