File Number:

F1501004/no.proy/bl/th/no.
Job Application Date:
00/00/00
PT. Satyamitra Surya Perkasa
Document Number:
Engineering, Procurement & Construction Rev. 0 File Rev.: 2 Page: 1 /8
R.PA4.002

HO Project : Project No :

For Applicants: We appreciate your interest to work in our company and we are also interested in your qualifications.
Clear and thorough understanding of your background and your work experience will greatly assist us in placing you in the right position
and in accordance with the qualifications you possess, and also for your career path in the future

If the available fields are not sufficient, please write them on a separate paper.

The desired position :

PERSONAL DATA
1.
Full Name :
2.
ID Number :
3.
Place/Date of Birth :
4.
Gender : Male / Female
5.
Address :

Phone Number : E-mail:

Home Status : Rented Contract Parent Private
Others
6.
Religion :
7.
Nationality :
8.
Education : Degree:
9.
Marital Status : Single Married
10.
Who advised you apply to PT Surya Perkasa Satyamitra?

RELATIVES
1.
PARENTS
Father Mother
a) Full Name
b) Age
c) Nationality
d) Religion
e) Education
f) Occupation
g) Address & Phone

2. SIBLINGS

Number of: old Brother ______, old sister ______, young brother ______, young sister ______
 File Number:
F1501004/no.proy/bl/th/no.
Job Application Date:
00/00/00
PT. Satyamitra Surya Perkasa
Document Number:
Engineering, Procurement & Construction Rev. 0 File Rev.: 2 Page: 2 /8
R.PA4.002

3. SPOUSE
Name :
Age :
Nationality :
Occupation :

4. CHILDREN
Number of: son ______, daughter ______, Number of children covered ______
NO. NAME B/G *) AGE EDUCATION OCCUPATION

*) B = Boy; G = Girl

5. Do you have family / acquaintances working at PT Satyamitra Surya Perkasa?

NO YES, specify:
NAME POSITION RELATION
 File Number:
F1501004/no.proy/bl/th/no.
Job Application Date:
00/00/00
PT. Satyamitra Surya Perkasa
Document Number:
Engineering, Procurement & Construction Rev. 0 File Rev.: 2 Page: 3 /8
R.PA4.002

EDUCATIONAL BACKGROUND
NAME & SCHOOL P / NP DIPLOMA /
LEVEL MAJORS TIME
ADDRESS *) DEGREE
ELEMENTARY

JUNIOR

HIGH

ACADEMY

UNIVERSITY

*) P = Pass; NP = Not Pass

TRAINING AND COURSE:

TYPE OF P/NP TYPE OF
NO NAME & ADDRESS DURATION
TRAINING *) **) CERTIFICATE ***)

*) JENIS PELATIHAN: Training or Course or Seminar or Workshop or Orientation

**) P = Pass; NP = Not Pass
***) TYPE OF CERTIFICATE: Graduation or Attendance or Expertise
 File Number:
F1501004/no.proy/bl/th/no.
Job Application Date:
00/00/00
PT. Satyamitra Surya Perkasa
Document Number:
Engineering, Procurement & Construction Rev. 0 File Rev.: 2 Page: 4 /8
R.PA4.002

WORK EXPERIENCES
Describe clearly and briefly your work experience (starting from the last job)
1. Company name :
Company's address :
Phone :
Type of business :
Duration of Work :
First Position : Last Position :
Recent Job Description :

Superior Name :
: Last Salary :
The Reason for Quit :

2. Company name :
 File Number:
F1501004/no.proy/bl/th/no.
Job Application Date:
00/00/00
PT. Satyamitra Surya Perkasa
Document Number:
Engineering, Procurement & Construction Rev. 0 File Rev.: 2 Page: 5 /8
R.PA4.002

Company's address :
Phone :
Type of business :
Duration of Work :
First Position : Last Position :
Recent Job Description :

Superior Name :
: Last Salary : :
The Reason for Quit :

3. Company name :
Company's address :
Phone :
Type of business :
Duration of Work :
First Position : Last Position :

Recent Job Description :

Superior Name :
: Last Salary :
The Reason for Quit :

4. Company name :
Company's address :
Telepon :
Type of business :
Duration of Work :
First Position : Last Position :
Recent Job Description :
 File Number:
F1501004/no.proy/bl/th/no.
Job Application Date:
00/00/00
PT. Satyamitra Surya Perkasa
Document Number:
Engineering, Procurement & Construction Rev. 0 File Rev.: 2 Page: 6 /8
R.PA4.002

Superior Name :
: Last Salary :
The Reason for Quit :

Notes:
Can we contact the company you wrote above? YES NO
If not, please write down which company you do not want us to contact.

SKILLS
1. Foreign Languages / Local Languages Mastered:
a) Speaking / Reading / Writing

b) Speaking / Reading / Writing

c) Speaking / Reading / Writing

2. Using a computer type:
Program: a) d)
b) e)
c) f)

ACTIVITY / ORGANIZATION ACTIVITIES

Mention organizations that have been or still followed since high school until now:
ORGANIZATION NAME TIME POSITION / STATUS

REFERENCES
Mention 3 people who can provide references (which has no family relationship):
NAME ADDRESS OCCUPATIONAL / POSITION
 File Number:
F1501004/no.proy/bl/th/no.
Job Application Date:
00/00/00
PT. Satyamitra Surya Perkasa
Document Number:
Engineering, Procurement & Construction Rev. 0 File Rev.: 2 Page: 7 /8
R.PA4.002

OTHERS
1.
If you hired, when can start work?

2.
Expected salary?

3.
Do you have a physical / health condition that will hamper your ability to perform the tasks in accordance
with the position you want?

4.
Have you been involved in a crime in the last 5 (five) years?

5.
Give a brief description of yourself.
(What is important in life? What is your motivation in pursuing success? What is your desire / goal?
What others think about you?)

PLEASE READ AND SIGNED

The descriptions I put on this work application are made honestly, completely, and seriously. I
understand if after I was accepted as a SSP employee and it was later found out that what I wrote in this
work application was incorrect / unsuitable, then I was willing to accept sanctions.

If I am accepted as an employee of PT Satyamitra Surya Perkasa, I am willing to comply and obey the
applicable company regulations, and if I violate the rule, I am willing to accept sanctions.

Jakarta, _____________________________
Signature / Full Name

* Filled by Officers

TEST RESULTS
 File Number:
F1501004/no.proy/bl/th/no.
Job Application Date:
00/00/00
PT. Satyamitra Surya Perkasa
Document Number:
Engineering, Procurement & Construction Rev. 0 File Rev.: 2 Page: 8 /8
R.PA4.002

Interviewed by: ______________________________________________________________________

* Filled by Officers

PROPOSING AND APPROVAL

Position :
Salary :
Medical Allowance :
Holiday Allowance :
Meal Allowance :
Transport Allowance :
Other Allowance :
Overtime :
Start Working :
Probation Period :
Other :