Scribd
Upload
39 views

Employement Application Form 2014

This document is an employment application form for the post of [blank] at PT. Daikin Applied Solutions Indonesia. It requests personal details, education history, employment history, languages spoken, computer skills, and references for the applicant. The applicant provides their name, address, citizenship details, languages spoken, educational qualifications from high school through any postgraduate degrees. Previous employment details including positions, salaries, duties and reasons for leaving are listed. The applicant's medical history, availability to travel, and career objectives are also stated. Character references and an authorization for the information to be verified are provided at the end.

Uploaded by

Siswantoe
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
39 views

Employement Application Form 2014

This document is an employment application form for the post of [blank] at PT. Daikin Applied Solutions Indonesia. It requests personal details, education history, employment history, languages spoken, computer skills, and references for the applicant. The applicant provides their name, address, citizenship details, languages spoken, educational qualifications from high school through any postgraduate degrees. Previous employment details including positions, salaries, duties and reasons for leaving are listed. The applicant's medical history, availability to travel, and career objectives are also stated. Character references and an authorization for the information to be verified are provided at the end.

Uploaded by

Siswantoe
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 4

CONFIDENTIAL

(Recent Photo of
Applicant)

Jl. Kayoon 42-44. Surabaya 60271


Jl. Pancoran Barat VII, Duren Tiga, Jakarta Selatan 12760
Indonesia

EMPLOYMENT APPLICATION FORM


1. General Information
Post Applied For :
_______________________________________________
Source : Advertisement/Employment
Agency/Recommended by : _________________________

Expected Salary :
________________________________________
Earliest commencement date :
_______/_________/_________

2. Personal Particulars
Full Name :

Nick Name :

Address :

Sex : ( M / F )

Citizenship Card No./KTP No. :

NPWP No. :

Home Tel. No. :


Office Tel. No :
Handphone No:
E Mail :

Passport No.& Driving License


No. :

Place & Date of Birth:

Race/Ethnic Group :

Religion :

Marital Status :

Blood Type :

Nationality :

Do you wear glasses ?


( Y / N)

3. Family Details
(Please provide details of spouse / children / parent / siblings below)
Name
Relationship
Date of Birth

In case of emergency, please contact :


Name :
4. Proficiency in Languages / Dialects
Language/Dialects

5. Educational Details
Year
Educational
Background
From
To
High School
Diploma (D1/2/3/4)
Degree (S1)
Master (S2)
Other

Relationship :

Twitter/FB/LinkedIN :

Occupation

Marital Status

Contact No :

Spoken (Please Tick)


Good
Fair
Slight

Name & Address of Institution


Attended

Written (Please Tick)


Good
Fair
Slight

Highest Qualification
Obtained

Page 1 of 4

CONFIDENTIAL
6. Other Training / Professional Qualifications
Year
Type/Subject of Training & Courses
From

Type/Subject of Courses

Name of Institution

Expected
Qualifications

To

8. Awards / Scholarships
Year
From

Certificate Obtained
(Please Tick)

To

7. Courses Currently Pursuing


Year
From

Name of Institution

Award

Institutions Name of Presenting Award

To

9. Extra Curricular Activities / Professional Membership


Year
Institution/Organization
From

Position Held / Activity

To

10. Software Proficiency


Application Software /
Programming Language

Proficient

Familiar

11. Employment History


Present Employment :
From (dd/mm/yy):

To (dd/mm/yy):

Employer:

Starting Position:

Last Position:

Duties & Responsibilities :

Starting Salary:

Last Drawn:

Other Remuneration/Allowances:

Reason for Leaving :

Notice Period Required by Present Company :

Commencing Date Available:

Slight

Nature of Business:

Expected Salary :

Page 2 of 4

CONFIDENTIAL
Previous Employment :
From (dd/mm/yy):

To (dd/mm/yy):

Employer:

Starting Position:

Last Position:

Duties & Responsibilities :

Starting Salary:

Last Drawn:

Other Remuneration/Allowances:

Reason for Leaving :

From (dd/mm/yy):

To (dd/mm/yy):

Employer:

Starting Position:

Last Position:

Duties & Responsibilities :

Starting Salary:

Last Drawn:

Other Remuneration/Allowances:

Reason for Leaving :

From (dd/mm/yy):

To (dd/mm/yy):

Employer:

Starting Position:

Last Position:

Duties & Responsibilities :

Starting Salary:

Last Drawn:

Other Remuneration/Allowances:

Nature of Business:

Nature of Business:

Nature of Business:

Reason for Leaving :

12. Current Position In Organization


In current employment, draw in the given space below, an organizational chart of department you are working in,
indicating with a tick (v) the position currently held by you.

No. of all staff in your present company :


No. of staff members in your Department :

No. Under your supervision :


Other :

13. Medical History And Other Information


A.
Are you suffering from any physical disability or illness that requires you to be an medication for
prolonged period
If YES, please specify :
B.
Have you ever been detained, charged or convicted by court of law in any country?
If YES, please specify :
C.
Have you ever been dismissed or suspended from employement?
If YES, please specify :
D. Are you willing to be travel outside Jakarta / Surabaya?
If YES, please specify :
E.
Are you willing to be placed in outside Jakarta / Surabaya ?
If YES, please specify which area do you prefer :

YES / NO

YES / NO
YES / NO
YES / NO
YES / NO

Page 3 of 4

CONFIDENTIAL
F.
G.
H.
I.

Do you own a car / motorcycle ?


If YES, pleace specify : ____________________________________
Are you a member of Jamsostek ?
If YES, please specify: KPJ No. _____________________ Jamsostek Branch :_________________
Have you ever applied before for a job in PT. Daikin Applied Solutions Indonesia?
If YES, please specify the date :_____________________
Do you have any relatives / friends working in PT. Daikin Applied Solutions Indonesia?
If YES, please specify :
Name
Department
Relationship

YES / NO
YES / NO
YES / NO
YES / NO

Add anything else which you fell may assist you in your application :

14. Character References


(give particulars of 2 referees (Other than relatives)
Name :
1

Address/Contact No / E-mail :

Job Title & Company Name :


No. of Years Known :
2

Name :

Address/Contact No / E-mail :

Job Title & Company Name :


No. of Years Known :

15. Objectives
Brieftly describe : (1) What kind of organization do you wish to work for ?
(2) What are your career objectives ?
(3) How do yo see your career developing over the next 3 years ?

16. DECLARATION
I hereby authorize the Company to verify any information provided by me in this application form as it deems fit.
I understand that a misrepresentation or omission of facts called for herein will be sufficient cause for cancellation of
consideration for employment or dismissal from the Companys service if I have been employed. I also understand
that my employment is subject to being declared medically fit for employment by the Company appointed panel of
doctors.

___________________________
Signature of Applicant

______________________
Date

Page 4 of 4

You might also like