Document No.
APPLICATION FORM
FM-HR-APP-INI-____-_______
POSITION APPLIED FOR *: EXPECTED SALARY *:
NAME:
CONTACT ADDRESS *: TELP *:
HP *:
EMAIL ADDRESS *:
PLACE, DATE OF BIRTH *:
MARITAL STATUS SINGLE MARRIED
FORMAL EDUCATION *
LEVEL NAME OF SCHOOL * DEGREE * MAJOR * FROM - TO * GPA *
SENIOR HIGH SCHOOL
UNIV./ COLLEGE
UNIV./ COLLEGE
INFORMAL EDUCATION
DATE/ PERIOD COURSE TITLE PLACE REMARK
FOREIGN LANGUAGE SKILLS PROFICIENCY: WORST = 1; BEST = 10
LANGUAGE LISTENING READING SPEAKING WRITING REMARK
TECHNICAL SKILLS (Please write down the most proficient skills)
NO. SKILLS NO. SKILLS
1 MS SQL SERVER 6
2 ACCOUNTING & TAXATION 7
3 8
4 9
5 10
ORGANIZATION/ SOCIAL ACTIVITIES
NAME OF ACTIVITIES POSITION YEAR REMARK
WORK EXPERIENCE (Please start with the most recent position)
DATE FROM * DATE TO * COMPANY & TYPE OF BUSINESS * POSITION * RECENT SALARY *
JOB DESCRIPTION *:
REASON FOR RESIGN *:
REFERENCE CHECK (Please provide at least 2 person from the company for reference check)
NAME * POSITION * PHONE NUMBER * RESULT
NOTES:
NAME * POSITION * PHONE NUMBER * RESULT
NOTES:
O-Rev.3/27-02-2017
DATE FROM * DATE TO * COMPANY & TYPE OF BUSINESS * POSITION * RECENT SALARY *
JOB DESCRIPTION *:
REASON FOR RESIGN *:
REFERENCE CHECK (Please provide at least 2 person from the company for reference check)
NAME * POSITION * PHONE NUMBER * RESULT
NOTES:
NAME * POSITION * PHONE NUMBER * RESULT
NOTES:
OTHERS
YES NO DESCRIPTION
Have you been sick in the last 6 months? *
Do you mind working in any section in this company? *
Are you willing to travel? *
When would you be able to join this company? *
Please describe yourself:
What are your plans for the future?
I certify that the information on this application is correct and I understand that any misrepresentation or omission of any information will result
in my disqualification from consideration for employment or if employed my dismissal for just cause. PT Indodev Niaga Internet may verify the
information set forth on this application and obtain additional background information relating to my background. I authorize all persons,
schools, companies to supply all information concerning my background.
Applicant's Signature :
* Filled by HR & User
RECOMMENDATION: DECISION: DATE:
Signature:
O-Rev.3/27-02-2017