PT Jurong Engineering Lestari

Maspion Plaza Building Floor 10 Jl. Gunung Sahari Raya Kav.18 Jakarta 14420

APPLICATION FORM

USE CAPITAL LETTERS

Post applied for

I. PERSONAL DATA SHEET

A. Personal Details
BENNY SIAHAAN PRIA
Full name Sex
SERBELAWAN 29-09-1979 Religion KRISTEN
Place of Birth Date of Birth
Ethnic BATAK
Home Address & Phone Identity Card No. Marital Status
JLN.POGUNG DALANGAN NO.5B KTP - Married
SLEMAN TOGYAKARTA - Single
- Others √
Email : BENNY.HAAN2@YAHOO.COM
081355132879 6474032909790004

B. Family Details
(Spouse and children)
Name M/F Age Education Job Company
Spouse
Child 1 EVOLET SIAHAAN 10 SD NEGRI
Child 2
Child 3
Child 4

C. Family Details
(Father, Mother, brothers/sister including you)

Name M/F Age Education Job Company

Father KARIDEN SIAHAAN 70 SARJANA MUDA PNS
Mother TORONGAN SINURAT 65 SARJANA MUDA PNS
Bro./Sis. 1 ROGANDA SIAHAAN 49 S1 STAFF BANK
Bro./Sis. 2 MANGASI SIAHAAN 47 S1 STAFF INDOFOOD
Bro./Sis. 3 POSMA SIAHAAN 45 D3 PNS
Bro./Sis. 4 MIDUK SIAHAAN 43 S1 WIRAUSAHA
Bro./Sis. 5
D. Health History
1. Have you had a rather severe illness/accident Month / Year
If yes, please describe

2. Does it have a side effect presently ? X

If yes, please describe

II. EDUCATION AND SKILL

A. Formal Education
Education School’s Name Major ….. to ….. GPA
High Scholl SMU 4 PEMATANG SIANTAR
Academy
University UNIVERSITAS JANABADRA 2005 2010 2,79
YOGYAKARTA

B. Non Formal Education : Course/Training/Seminar

Field/Kind By Whom Level Year/Period Paid By
WELDING SLV CILEGON 2017
INSPECTOR

C. 1. Scientific Publication including thesis

2. Extra curricular/Social/Teaching activities

Name of activities/organization Position Year/Period

D. Languages (Fluent/slight)
Listening Speaking Writing
Language
Fluent Fair Slight Fluent Fair Slight Fluent Fair Slight
1. INGGRIS √ √ √
2.
3.

E. Hobbies/Sports
BOLA KAKI,BOLA VOLLY
 F. Scholarship/awards/prizes received :

III. WORK EXPERIENCE

(Four latest experiences, others please attach on separate page)

Period Name/Address/Phone of Company Position : WELDING TRACKING

PT. INTI KARYA PERSADA TEKNIK First : 2011
Last : 2013
Net Salary : 8000000
Type of Business QUALITY CONTROL Total Employees
Name of Supervisor RICO ARNOLD Name of Director RIZAL SATIRI
Major Tasks & Responsibilities
MEMBUAT PROGRESS WELDING DAN INPUT DATA DAN PREPARE TEST PACKAGE
Major Achievement

No. of employees supervised Directly Indirectly

Major reason for change
Minor reason for change

Period Name/Address/Phone of Company Position WELDING TRACKING

PT. INTI KARYA PERSADA TEKNIK First : 2013
Last : 2015
Net Salary : 10000000
Type of Business QUALITY CONTROL Total Employees
Name of Supervisor IHKSAN Name of Director ENDAR
Major Tasks & Responsibilities
OPERATOR PWCS DAN REVIEW TEST PACKAGE

Major Achievement

No. of employees supervised Directly Indirectly

Major reason for change
Minor reason for change

Period Name/Address/Phonof Company Position KOORDINATOR

WELDING TRACKING
PT.KONSORSIUM WIKA & TECHNIP First : 2015
Last : 2017
Net Salary : 13000000
Type of Business Total Employees
Name of Supervisor RUSTAM Name of Director RIZAL SATIRI
 Period Name/Address/Phone of Company Position: WELDING INSPECTOR
PT.JURONG ENGINERING LESTARI (JEL) First : 2017
Last : 2017
Net Salary : 10000000
Type of Business Total Employees
Name of Supervisor SIGIT W Name of Director ANTOS SRIADI
Major Tasks & Responsibilities
PREPARE TEST PACKAGE DAN HIDROTEST

Major Achievement

No. of employees supervised Directly Indirectly

Major reason for change
Minor reason for change

IV. CURRENT OR LAST WORK CONDITIONS – SALARY & BENEFIT

Basic salary 7000000 Co. Car
Take home pay 12000000 House (per month)
THR
Bonus Medical
Commission 1.BPJS
Allowance 2.
1. Lunch 900000 3.
2. Meal 1500000 Other :
3. Project 3000000 1.
4. 2.

V. SALARY AND COMMENCEMENT OF EMPLOYMENT

1. Desired basic monthly salary ? 6000000
2. Earliest date able to commence employment SECEPATNYA

I declare that the statement mad on this document are true and correct.

Jakarta,

( BENNY SIAHAAN )
REFERENSI
ApakahSaudaratidakkeberatanuntukmemberikan 3 referensidariperusahaanSaudarasebelumnya ? Yes No
√
NAMA ALAMAT & TELEPON NAMA PERUSAHAAN PEKERJAAN / POSISI

RICO ARNOLD 081344232215 PT.IKPT KOORDINATOR QC

RUDI 082126679880 PT.IKPT KOORDINATOR QC
RIZAL SATIRI 081143321334 PT.KONSORSIUM QC MANAGER
WIKA & TECHNIP


TAMBAHAN INFORMASI
GAJI POKOK PER BULAN 7000000 FASILITAS YANG LAIN BPJS
BONUS/AWS(TETAP) 4000000 GAJI MIN. YANG DIMINTA 12000000
KOMISI/TUNJANGAN 2000000 JARAK WAKTU PENGUNDURAN
DIRI

KEMAMPUAN KOMPUTER BAGUS

(Tolong dijelaskan program aplikasi (perangkat lunak dan tidak lunak dengan tingkat kemahiran: Bagus,
rata-rata)

TOLONG BERIKAN TANDA CONTRENG () DI DALAM KOTAK YANG TERSEDIA Ya Tidak

Apakah Saudara mempunyai teman atau saudara yang bekerja di Perusahaan ini √
(Mohondituliskan)
Apakah Saudara bersedia melakukan perjalanan dinas keluar kota ? √
Apakah Saudara bersedia ditempatkan di luarJawa ? √
Apakah Saudara bersedia kerja lembur ? √
Apakah Saudara pernah ditahan, dituduk atau dituntut dimuka pengadilan sebagai tertuduh dalam √
tindakan criminal ?
Apakah Saudara pernah menderita sakit yang serius ?Jika “ya” berikan keterangan √

Apakah Saudara pernah meminum atau pengguna narkoba ? √

Apakah Saudara terlibat atau mempunyai usaha yang lain ? √
Apakah Saudara mempunyai pendapatan di luar dai gaji pokok ?Jika “ya” mohon disebutkan. √

Pernyataan :
Saya menyatakan bahwa pernyataan diatas adalah benar.

Anyer, 30 Agustus 2018

( BENNY SIAHAAN )
INTERNAL PROCESS
Interview by Initials & Date Comments and Suggestions
(Name/Position/Function

RECOMMENDATION & APPROVAL

start working
Mark (X) in the box in below
Section / Dept
Accepted
Not accepted Superior

Classification

Level /Tingkat

Jabatan / Position

HRD Budget Holder / Dept Approved

Piter Jayakarta Antos Sriandi Nanang Irwanto

HR. Coordinator Site Manager Project Manager