ANI Job Application

PT.
AERO NUSANTARA INDONESIA
HR Department, Hangar IV Calibration Budiarto Airport, Jl Raya PLP Curug 5 Legok Tangerang - 15
Phone.+6221-5462203-08 Fax.+6221-5474499 Website: ani.co.id
APPLICATION FOR EMPLOYMENT

The application should be completed in English
Position applied for :
Technician to Engine Team
Date :
June 16, 2015
How were you reffered to us?

Newspaper Ad
School
Recruitment/Manpower agency
On my own
Other:
ANI employee
Lazarus Crishtofel Koilher

(name of referral source)
PERSONAL DETAILS
Full Name:
Kustiawan Saputra
Blood Type:
Nick Name:
Kusti
Weight:
65
kg
Mothers Name:
Popon
Height:
168
cm
Gender:
Male
Marital Status:
Single
Birth Place:
SUKABUMI
Status Date:
Date of Birth:
6/23/1991
Religion:
Moslem
Nationality:
Indonesia
(if married - dd.mm
( dd.mm.yyyy )
IDENTITY CARD DETAILS

KTP Number:
3202272306910000
KTP Expired:
SIM A Number:
6/23/2018
910613260161
SIM A Expired:
SIM C Number:
Jamsotek Number:
( dd.mm.yyyy )
6/23/2015
NPWP Number:
( dd.mm.yyyy )
Member Date:
( dd.mm
( dd.mm
Member Date:
910613260057
SIM C Expired:
6/23/2018
( dd.mm.yyyy )
CONTACT DETAILS
Current Address
Address:
Address on KTP:
Sarijadi blok 2 no.110
Address:
Jl. Pelda km 12 03/03 Sirnaresmi vil

Gunungguruh Subdistrict
City:
Bandung
City:
Sukabumi
Postal Code:
Postal Code:
43157
Phone:
Phone:
6285624161739
Mobile Phone:
6285624161739
Email:
kustiawan_s@yahoo.com
PT. AERO NUSANTARA INDONESIA
FAMILY DETAILS
Name
Relation
Gender
Birth Place
Birth Date
Address
EMAN SULAEMAN
FATHER
MALE
SUKABUMI
1/1/1967
Jl. Pelda km 12 RT.03 RW
POPON
MATHER
FEMALE
SUKABUMI
10/23/1975
SRI PUTRI HANDAYANI
SISTER
FEMALE
SUKABUMI
2/1/1997
SYAMSUL SAPUTRA
BROTHER
MALE
SUKABUMI
6/22/2001
EDUCATION & OTHER QUALIFICATIONS

Formal Education
Level
School Name
SD
SDN GENTRAMASEKDAS
City
Major
SUKABUMI
N/A
SMP
MTS SAHID
BOGOR
N/A
SMK
BOGOR
BANDUNG
Teknik Mesin
AKTEK AERONAUTIKA SILIWANG
BANDUNG
Aeronautika
Diploma III
*) SMU, SMK, SMEA, STM, Etc.

**) DI, DII, DIII
Informal Education, Training, Courses, Seminar
Subject/Topic
Name of Institution
Period (dd.mm.
COMPUTER TRAINING (MS.OFFICE)
MAESTRO COMPUTER SUKABUMI
3/1/2003
ENGLISH COURSE
HEC ENGLISH VILLAGE (KEDIRI - WEST JAVA)
8/25/2010
ENGLISH COURSE
BEC ENGLISH VILLAGE (KEDIRI - WEST JAVA)
11/27/2010
CAD/CAM COURSE
BBPLKDN (BANDUNG - WEST JAVA)
7/14/2014
NATIONAL SEMINAR ON AEROSPACE
STTA YOGYAKARTA
10/8/2011
BLOOD DONOR ACTIVITY AND CHARITY
SMKN 12 BANDUNG
10/1/2010
General License
License Code *
License Number
Participant Number
Examination Number
AME License
AMEL Number:
Rating
Issued Date
Holder Address:
Date Issued:
Date Expired:
*) AF : Airframe, AV : Avionics, EL : Elictrical, EN : Engine
GS : GSE Operator, IN Instrument, RD : Radio
**) B732 : Boeing 737-200, B737S : Boeing 737-300/400/500
MD80 : MD 80 Series, JT8DS : JT8D Series
Category *
Rating Type **
Foreign Language
Language
Spoken
English
Poor
X Fair
Fluent
Poor
X Fair
Poor
X Fair
Fluent
Poor
X Fair
X Poor
Fair
Fluent
X Poor
Fair
Arab
German
Written
Computer Skills
What computer programming languages and operation systems are you most proficient in?
Computer Program
Basic
Intermediate
Advance
Others, please specify:
Microsoft Office:
Word
Excell
Power Point
Project
Outlook
________________
________________
________________
*) Place a tick mark (V) on the provided column
Membership of Professuonal, Social, or Political Activities

Name of Organization
Type of Organization
Period
Activities
Po
Leisure interest/Sports/Hobbies
Playing Basket ball and Reading a Book
GENERAL
1. Have you been or are you suffering from any serious ailment or physical disability?
2. Have you ever applied for any post with ANI ?
I never.
I never.
3. Have you previously been employed by this company?
I never.
4. Have you any relative*) working with ANI ?
I don't have any relative
5. Are you willing to work overtime?
YES, I am willing to wor
6. Are you willing to travel?
YES, I am willing to trav
7. Are you willing to relocate?
YES, I am willing to relo
8. Are you willing to work in office or fields?
YES, I am willing to wor
*) Relatives are: wife/husband, mother/father, son/daugther, sister/brother, aunt/uncle, niece/nephew,

stepchildren, cousin, grandparent/grandchild, I-laws.
EMPLOYMENT HISTORY (start with current job, including temporary work and vocational training)
Employer:
How were you reffered to this company?
Nature of business:
Employment period:
Address & Phone No.:
From (MM,YY)
To (MM,YY)
Product / Services:
Position on Joining:
Employment status:
Position on Leaving:
Work schedule:
Monthly salary & benefits:
Describe briefly your job & any significant accomplishment:
Supervisor's name/title:
May we contact?
Yes
No, please explain:
Reason for leaving:
Employer:
Nature of business:
Employment period:
From (MM,YY)
To (MM,YY)
Product / Services:
Employment status:
Work schedule:
May we contact?
Yes
No, please explain:
Reason for leaving:
Employer:
Nature of business:
Employment period:
From (MM,YY)
To (MM,YY)
Product / Services:
Employment status:
Work schedule:
May we contact?
Yes
No, please explain:
Reason for leaving:
Employer:
Nature of business:
Employment period:
From (MM,YY)
To (MM,YY)
Product / Services:
Employment status:
Work schedule:
May we contact?
Yes
No, please explain:
Reason for leaving:
Employer:
Nature of business:
Employment period:
From (MM,YY)
To (MM,YY)
Product / Services:
Employment status:
Work schedule:
May we contact?
Yes
No, please explain:
Reason for leaving:
COMMENCEMENT & SALARY EXPECTATION

1. If you are offered employment with us, when can you start working?
as soon as possible
2. What is your salary expectation if you are offered employment with us?
about 3 million
DECLARATION
I authorize the investigation of all information provided by me in this Application for Employment Form except
those pertaining to my current employment, I understand that as part of recruitment process, ANI will ask me to submit
copies of reference letter of my current and previous employers, copies of relevant certificates, copies of latest salary
slip and check my references. I also 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 ANI's service if I have been
employed.
Date:
Signature of Applicant:
You can send by email to vacancy-hrd@ani.co.id
USANTARA INDONESIA
tion Budiarto Airport, Jl Raya PLP Curug 5 Legok Tangerang - 15820
5462203-08 Fax.+6221-5474499 Website: ani.co.id
ON FOR EMPLOYMENT
ANI employee
(if married - dd.mm.yyyy)
( dd.mm.yyyy )
( dd.mm.yyyy )
Jl. Pelda km 12 03/03 Sirnaresmi village

Gunungguruh Subdistrict
Sukabumi
43157
6285624161739
USANTARA INDONESIA
USANTARA INDONESIA
Address
Jl. Pelda km 12 RT.03 RW.03 Sirnare
Graduate Date
1999-2005
2005-2007
2007-2010
2011-2014
Period (dd.mm.yyyy)
6/27/2003
11/27/2010
2/27/2011
8/27/2014
10/8/2011
10/1/2010
*) A1, A2, A3, A4

C1, C2, C3, C4
USANTARA INDONESIA
USANTARA INDONESIA
Fluent
Fluent
Fluent
Others, please specify:
Position
I never.
I never.
USANTARA INDONESIA

I never.
I don't have any relative working wi
YES, I am willing to work overtime.
YES, I am willing to travel.
YES, I am willing to relocate.
YES, I am willing to work in office o
USANTARA INDONESIA
USANTARA INDONESIA
USANTARA INDONESIA
as soon as possible
about 3 million
s Application for Employment Form except
rt of recruitment process, ANI will ask me to submit
pies of relevant certificates, copies of latest salary
ation or omission of facts called for herein will be

dismissal from the ANI's service if I have been
USANTARA INDONESIA
mail to vacancy-hrd@ani.co.id

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PT.

AERO NUSANTARA INDONESIA

APPLICATION FOR EMPLOYMENT

Technician to Engine Team

June 16, 2015

How were you reffered to us?

Lazarus Crishtofel Koilher

(if married - dd.mm

IDENTITY CARD DETAILS

Jl. Pelda km 12 03/03 Sirnaresmi vil

PT. AERO NUSANTARA INDONESIA

PT. AERO NUSANTARA INDONESIA

Jl. Pelda km 12 RT.03 RW

Jl. Pelda km 12 RT.03 RW

SRI PUTRI HANDAYANI

Jl. Pelda km 12 RT.03 RW

Jl. Pelda km 12 RT.03 RW

EDUCATION & OTHER QUALIFICATIONS

AKTEK AERONAUTIKA SILIWANG

*) SMU, SMK, SMEA, STM, Etc.

COMPUTER TRAINING (MS.OFFICE)

MAESTRO COMPUTER SUKABUMI

HEC ENGLISH VILLAGE (KEDIRI - WEST JAVA)

BEC ENGLISH VILLAGE (KEDIRI - WEST JAVA)

BBPLKDN (BANDUNG - WEST JAVA)

NATIONAL SEMINAR ON AEROSPACE

BLOOD DONOR ACTIVITY AND CHARITY

PT. AERO NUSANTARA INDONESIA

PT. AERO NUSANTARA INDONESIA

Others, please specify:

Membership of Professuonal, Social, or Political Activities

PT. AERO NUSANTARA INDONESIA

4. Have you any relative*) working with ANI ?

I don't have any relative

5. Are you willing to work overtime?

YES, I am willing to wor

6. Are you willing to travel?

YES, I am willing to trav

7. Are you willing to relocate?

YES, I am willing to relo

8. Are you willing to work in office or fields?

YES, I am willing to wor

*) Relatives are: wife/husband, mother/father, son/daugther, sister/brother, aunt/uncle, niece/nephew,

PT. AERO NUSANTARA INDONESIA

How were you reffered to this company?

Address & Phone No.:

Monthly salary & benefits:

Describe briefly your job & any significant accomplishment:

Reason for leaving:

How were you reffered to this company?

Address & Phone No.:

Monthly salary & benefits:

Describe briefly your job & any significant accomplishment:

Reason for leaving:

How were you reffered to this company?

Address & Phone No.:

Monthly salary & benefits:

Describe briefly your job & any significant accomplishment:

Reason for leaving:

PT. AERO NUSANTARA INDONESIA

PT. AERO NUSANTARA INDONESIA

How were you reffered to this company?

Address & Phone No.: