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Personal Data: Name Date of Birth Occupation Place

This document contains an application form for an applicant interested in a position at an organization. The form requests personal details such as contact information, education history, work experience, languages spoken, activities/hobbies, references, and health information. It notes that the applicant understands false statements are grounds for dismissal. The organization requests supporting documents and states submitted materials will not be returned.

Uploaded by

Cici Cassiopeia
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
92 views

Personal Data: Name Date of Birth Occupation Place

This document contains an application form for an applicant interested in a position at an organization. The form requests personal details such as contact information, education history, work experience, languages spoken, activities/hobbies, references, and health information. It notes that the applicant understands false statements are grounds for dismissal. The organization requests supporting documents and states submitted materials will not be returned.

Uploaded by

Cici Cassiopeia
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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To Applicant

: We deeply appreciate your interest in our organization.


We need a clear understanding of your background and work history in
orienting you to the position that best meets your qualifications and
may assist us in possible future development.

PHOTO (3x4)

PERSONAL DATA
Full Name

Telephone :

Present Address

Business : .
Home : ..
Mobile (HP) : ...

Permanent Address

e-mail Address :
...
Passport No. (if any) :
...

Place & Date of Birth

Religion

Sex

Male

Female

Marital Status

Single

Married

Spouse (Wife / Husband) :


Name

Children :
No.
1
2
3
4

Name

Date of birth

Divorced / Widower / Separated

Occupation

Sex

Place

Date of birth

Place

Date of birth

Place

Parents :
Name
Fathers
Mothers
Brothers & Sisters :
1.
2.
3.
4.
5.

Occupation

WORK INTEREST
Position applied for

: .

Why did you choose this position ?

.
Other position (s) for which you consider to be qualified :
.. or
Monthly Salary expected (Gross) : Rp.
Would you agree to change your profession ?

Yes

No

Would you agree to work in remote area or developing country ?

Yes

No

EDUCATION BACKGROUND
School

Name and
Location
of School

From - To

Majoring

Titled Degree
Given

GPA

Elementary
Jr. High
Sr. High
Academy
University :
- Bachelor
- Master
- PhD

TRAINING / COURSE RECORDS


Subject of Training

From - To

Organized by

1.
2
3.
4.
5.
6.

FOREIGN LANGUAGE SKILLS


Language
English
Indonesia
Japan

Read
F

G V E

Write
F

G V E

Speak
F

G V E

F = Fair
G = Good
V = Very Good
E = Excellent

Location

EMPLOYMENT RECORDS
List all present and past employment records, starting with the most recent one.

1. Period

: to .

Company

: ..

Type of business

: ..

Starting position

: ..

Position at leaving

: ..

Starting salary

: (gross / net)

Salary at Leaving

: .(gross / net)

2. Period

: to .

Company

: ..

Type of business

: ..

Starting position

: ..

Position at leaving

: ..

Starting salary

: (gross / net)

Salary at Leaving

: .(gross / net)

3. Period

: to .

Company

: ..

Type of business

: ..

Starting position

: ..

Position at leaving

: ..

Starting salary

: (gross / net)

Salary at Leaving

: .(gross / net)

4. Period

: to .

Company

: ..

Type of business

: ..

Starting position

: ..

Position at leaving

: ..

Starting salary

: (gross / net)

Salary at Leaving

: .(gross / net)

5. Period

: to .

Company

: ..

Type of business

: ..

Starting position

: ..

Position at leaving

: ..

Starting salary

: (gross / net)

Salary at Leaving

: .(gross / net)

6. Period

: to .

Company

: ..

Type of business

: ..

Starting position

: ..

Position at leaving

: ..

Starting salary

: (gross / net)

Salary at Leaving

: .(gross / net)

7. Period

: to .

Company

: ..

Type of business

: ..

Starting position

: ..

Position at leaving

: ..

Starting salary

: (gross / net)

Salary at Leaving

: .(gross / net)

8. Period

: to .

Company

: ..

Type of business

: ..

Starting position

: ..

Position at leaving

: ..

Starting salary

: (gross / net)

Salary at Leaving

: .(gross / net)

ACTIVITIES & HOBBIES


Membership of Professional Association :
..
..
Hobbies & Sports :
..
..
Social Activities :
..
..

PERSONAL REFERENCES
(Former Employers or Lecturers)

Name
Occupation
Address

:
:
: .
.

Name
Occupation
Address

:
:
: .
.

HEALTH
Detail of serious illness (if any):
..
..

ADDITIONAL INFORMATION
..
..
The facts stated in this application for employment are true and complete to the best of my knowledge and
belief. I understand that false information in this application shall be considered sufficient for dismissal for
employment.

Date : ____________________

Applicants Signature :

Please supply documentary evidence which supports the statements you have made above. Do not, in any
event, submit the originals of references, testimonials, certificates or diplomas, unless they have been
obtained for the sole use of PT. JGC Indonesia.
Photographs and documents are non returnable and shell thereafter be deemed to be the property of PT. JGC
Indonesia.

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