APPLICATION FORM
: Name
: Job Position
: Company
PERSONAL IDENTITY 2 3
Education Information
Level School From End Major
Full Name : ……………………………………………………………………………………… Elementary
Place and Date of Birth : ……………………………………………………………………………………… Junior High Schoold
Gender : ……………………………………………………………………………………… Senior High School
Religion : ……………………………………………………………………………………… Diploma
Blood Type : ……………………………………………………………………………………… Bachelor Degree
Height : ……………………………………………………………………………………… Master Degree
Weight : ………………………………………………………………………………………
Marital Status : ……………………………………………………………………………………… Language 1. …………………………….. 3. ……………………………..
Nationality : ……………………………………………………………………………………… 2. …………………………….. 4. ……………………………..
ID No. : ………………………………………………………………………………………
SIM & No. : ………………………………………………………………………………………
Hobby : ……………………………………………………………………………………… Non Formal Education
……………………………………………………………………………………… Course Institution Year
Address (KTP) : ………………………………………………………………………………………
………………………………………………………………………………………
Address (Current) : ………………………………………………………………………………………
………………………………………………………………………………………
Phone No (Home) : ………………………………………………………………………………………
Phone No (HP) : ……………………………………………………………………………………… Skills and Computer Skills
1. 4.
Email : ……………………………………………………………………………………… 2. 5.
3. 6.
Employment Experience
Company Position Start End Salary Resign
Family Members
Name Gender DOB Relationship
1.
2.
3.
4.
5.
Emergency Contact :
Name : …………………… Achievement :
Address : …………………… ………………………………………………………………………………………………………
Phone No.. : ……………………
Relationship : ................................... Recommendation
Name Company Position Address
Do you have any relatives employed in this company?
Name :
Dept :
Position : I gave the information above in truth. I am ready to be responsible for
information above. I am willing to be assigned anywhere within Indonesia.
Current Salary and Beneficial
……………………………………………………………………………………………………… Place and Date …………………………………………….
………………………………………………………………………………………………………
Expected Salary and Beneficial
……………………………………………………………………………………………………… …………………………………….
……………………………………………………………………………………………………… Full Name
