HR.08 P1.4 PERSONAL DETAILS Name : Place / Date of Birth : / Sex : Male Female Religion : ID Card No. : Marital Status : Single Married No. Of Child : Address : Home Telp No. : Origin Address : FAMILY PARTICULAR EDUCATION LEVEL From lower until high level Parents, brother, sister spouse and children, includee your self NAME of SCHOOL AREA OF SPECIALISATION PLACE STANDARD PASSED (YEAR) (YEAR) START FINISH COMPANY PLACERELATIONSHIP E M P L O Y E E APPLICATION F O R M Office / Cell No. : NAME AGE OCCUPATION v v v v
HR.08 P2.4 TRAINING / COURSE ORGANIZATION MEMBERSHIP WORKING EXPERIENCE FROM (Year) NAME of ORGANIZATION POSITION TO (Year) ADDRESS NAME of INSTITUTE DURATION FINANCED BYSUBJECT YEAR Start from latest one PLACE PRODUCT FROM (Month/Year) TO (Month/Year) LAST POSITION - Other Allowance Reason of Leaving/Resign Name of Direct Supervisor No. Of Main Jobs Position of Direct Supervisor Employee PRODUCT FROM (Month/Year) TO (Month/Year) Last Salary : - Basic LAST POSITION Name of Direct Supervisor No. Of Main Jobs Position of Direct Supervisor Employee Reason of Leaving/Resign Last Salary : - Basic - Other Allowance SCHOOL / COMPANY1 SCHOOL / COMPANY2 ADDRESS ADDRESS
HR.08 P3.4 ADDITIONAL SKILLS LANGUAGE OTHER ACTIVITIES TO (Month/Year) LAST POSITIONADDRESS3 SCHOOL / COMPANY PRODUCT FROM (Month/Year) No. Of Main Jobs Position of Direct Supervisor Employee Name of Direct Supervisor Reason of Leaving/Resign Last Salary : - Basic - Other Allowance 4 SCHOOL / COMPANY PRODUCT FROM (Month/Year) TO (Month/Year) LAST POSITIONADDRESS Name of Direct Supervisor No. Of Main Jobs Reason of Leaving/Resign Last Salary : Position of Direct Supervisor Employee LAST POSITION - Basic - Other Allowance ADDRESS5 SCHOOL / COMPANY PRODUCT FROM (Month/Year) TO (Month/Year) No. Of Main Jobs Position of Direct Supervisor Employee Name of Direct Supervisor Reason of Leaving/Resign Last Salary : - Basic - Other Allowance LANGUAGEADDITIONAL SKILLS / KNOWLEDGE FAIRGOODEXCELENT HOBBY
HR.08 MEDICAL HISTORY P4.4 STRENGTH POINT WEAK POINT EXPECTED SALARY Say in word : Rp. I hereby certify that the information given above is true, and if under any circumtances any mispresentation or ommision of information is founs, I understand that I shall fully be held responsible. Date : KIND OF ILLNESS WHEN EFFECT UNTIL NOW