CANDIDATE INFORMATION PHOTO HERE

Full Name
Sex
Place, Date of
Birth
Religion
Nationality
Ethnic
Marital Status (Sum of children : )

Current Mailing Address: Permanent Mailing Address:

Own house Rented house Parents Own house Rented house Parents Others
Others
Tel. No. (Off) Tel. No. (Off)
(Res) (Res)

(H/P) Facs. (H/P) Facs.

E-mail: E-mail:
Driver License: Do you own a car:
Yes / No Yes / No

ACADEMIC INFORMATION
ACADEMIC INFORMATION

From To Schools, Colleges, Universities Major GPA Diploma

(Yes/No)

SEMINAR/COURSE/WORKSHOP
SEMINAR/COURSE/WORKSHOP
From To Topic Organizer & Location Certificate
(States dates) (Yes/No)

Start Date End Date Company Job Category

WORKING EXPERIENCE
WORKING EXPERIENCE
 EMPLOYMENT DETAILS
EMPLOYMENT DETAILS
Position :
Date of employment : until

Company
Company Address

Business Line
Current Position
Report directly
(Name/Position)
Total number of employees
Number of Sub-Ordinates
Job Description




Achievement


How did you get employed (Through Advertisement, Recommendation, etc.)
Reason for leaving
Last Drawn Salary

ORGANIZATION STRUCTURE
ORGANIZATION STRUCTURE
Sruktur organisasi perusahaan terakhir

EMPLOYMENT DETAILS
EMPLOYMENT DETAILS
Position :
Date of employment : until

Company
Company Address

Business Line
Current Position
Report directly
(Name/Position)
Total number of
employees
Number of Sub-Ordinates
Job Description




Achievement


How did you get (Through Advertisement, Recommendation, etc.)
employed
Reason for leaving
Last Drawn Salary

EMPLOYMENT DETAILS
EMPLOYMENT DETAILS

Position :
Date of employment : until

Company
Company Address

Business Line
Current Position
Report directly
(Name/Position)
Total number of
employees
Number of Sub-Ordinates
Job Description




Achievement


How did you get (Through Advertisement, Recommendation, etc.)
employed
Reason for leaving
Last Drawn Salary

EMPLOYMENT DETAILS
EMPLOYMENT DETAILS

Position :
Date of employment : until

Company
Company Address

Business Line
Current Position
Report directly
(Name/Position)
Total number of
employees
Number of Sub-Ordinates
Job Description




Achievement


How did you get (Through Advertisement, Recommendation, etc.)
employed
Reason for leaving
Last Drawn Salary

EMPLOYMENT DETAILS
EMPLOYMENT DETAILS

Position :
Date of employment : until

Company
 Company Address

Business Line
Current Position
Report directly
(Name/Position)
Total number of
employees
Number of Sub-Ordinates
Job Description




Achievement


How did you get (Through Advertisement, Recommendation, etc.)
employed
Reason for leaving
Last Drawn Salary

ADDITIONAL INFORMATION
ADDITIONAL INFORMATION
SPECIAL ACTIVITIES

From To Name of Organization Place Position

LANGUAGE SKILLS
Language Reading Writing Speaking Understanding

Notes: E = Excellent, G = Good, F = Fair, P = Poor

OTHER PERSONAL INFORMATION

 Computer Proficiency (Program/Language : )

Other Skills &

expertise
Interest

What do you do in your leisure time?

What are your hobbies?

Do you read: a lot few a little
What kind of topics do you read?
You subscribe to (newspaper, magazines, etc.):

Core competencies:
Have you been dismissed or suspended from any position? Yes No.
If so, state details
Are you engaged in any business? Yes No.
What kind of business?
Current Salary: Expected salary:
Details of current remuneration package:

Do you have any other sources of income? Yes No.

When are you available for work: Notice Period:

FAMILY DETAILS
FAMILY DETAILS
Relationship Name Age Last Education Occupation

Father
Mother
Husband/Wife
Child

Brothers/Sister

You have ____________brother(s)/sister(s) and are the _______________child in the family.

EMPLOYMENT REFERENCES
EMPLOYMENT REFERENCES
 Name: Name:

Position: Position:
Company Name: Company Name:
Company Address: Company Address:

Nature of Relationship: Nature of Relationship:

Tel: (Office) (Res) Tel: (Office) (Res)

By signing this form I certify that the information in this application is factually correct, honestly presented, and is
an accurate account of my professional experience. Should it be untrue, I would be prepared for a dismissal at any
time without any conditions.

Signature: __________________________ Date: _____________________________