Personal Data Form
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PERSONAL DATA PT SELNAJAYA PRIMA MidPlaza I Building, 19 th Floor Jl. Jend. Sudirman Kav. 10 - 11 Jakarta 10220 E-mail: [email protected] Url: www.selnajayarecruitment.com I. PERSONALITY FULL NAME * ( M / F ) PLACE / DATE OF BIRTH * CONTACT ADDRESS E-MAIL * TELEPHONE NUMBER * *(Mobile) *(Home) *(Emergency) EMERGENCY CONTACT NO. STATUS □ Married □ Single □ Divorced / Widowed OCCUPATION / (Present position) JOB APPLICATION IDENTITY NUMBER DRIVER LICENCE A / B1 / B2 / C OWN VEHICLE □ Yes □ No Car / Motorcycle NATIONALITY ETHNICITY BLOOD TYPE RELIGION CHARACTER HOBBIES COMPUTER SKILLS OTHER SKILLS LANGUAGES ABILITY □ English □ Japanese □ Indonesian □ Mandarin □ Others (………..…) EXPECTING SALARY (THP) Rp (Gross/Net) □ Negotiable Allowances : AVAILABILITY EXPECTING LOCATION Your wishes / expectations / notes towards your new job : * Required Fields (H: Home, M: Mobile, O: Office) Photo
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Transcript of Personal Data Form
PERSONNAL DATA
PERSONAL DATAPT SELNAJAYA PRIMA
MidPlaza I Building, 19th Floor
Jl. Jend. Sudirman Kav. 10 - 11 Jakarta 10220E-mail: [email protected]
Url: www.selnajayarecruitment.com
I. PERSONALITY
FULL NAME * ( M / F )
PLACE / DATE OF BIRTH *
CONTACT ADDRESS
E-MAIL *
TELEPHONE NUMBER **(Mobile) *(Home)
*(Emergency)
EMERGENCY CONTACT NO.
STATUS Married Single Divorced / Widowed
OCCUPATION / (Present position)
JOB APPLICATION
IDENTITY NUMBER
DRIVER LICENCE A / B1 / B2 / COWN VEHICLE Yes NoCar / Motorcycle
NATIONALITYETHNICITY
BLOOD TYPERELIGION
CHARACTERHOBBIES
COMPUTER SKILLSOTHER SKILLS
LANGUAGES ABILITY English Japanese Indonesian Mandarin Others (..)
EXPECTING SALARY (THP)Rp (Gross/Net) Negotiable
Allowances :
AVAILABILITY
EXPECTING LOCATION
Your wishes / expectations / notes towards your new job :
* Required Fields (H: Home, M: Mobile, O: Office)II. List of References(Your professional contact references for recommendation)NAMERELATIONOCCUPATION / LOCATIONPHONE
III. EDUCATION, SEMINAR & LICENCES
FORMAL EDUCATION (Last Education & High School)NAME of SCHOOL / PLACEMAJORPERIOD *DEGREE**GRADUATE
(Y/N)
START - END
(DD/MM/YY DD/MM/YY)
** SMA/U, STM, SMEA, D1, D2, D3, D4, S1, S2, S3, etc.
INFORMAL EDUCATION NAME of SCHOOL / PLACEMAJORPERIOD *(YEAR)CERTIFICATEGRADUATE
(Y/N)
ATTENDED SEMINARNAME of SEMINARORGANIZATION / PLACEPERIOD *(YEAR)CERTIFICATE(Y/N)
CERTIFICATIONS***NAME of CERTIFICATIONSORGANIZATION / PLACE / YEAR LEVEL
*** Brevet A & B, CPA, CCNA, TOEFL, TOEIC, Japanese Proficiency Test, EtcIV. WORKING EXPERIENCE
(Fill in the following form based on the number of job changes youve had, starting with your current or most recent job)COMPANY NAME *
COMPANY ADDRESS *
INDUSTRY *
COMPANY CATEGORY LOCAL PMA Joint Venture (Company Origin) :
LAST POSITION *EMPLOYMENT STATUS : Contract Permanent
POSITION LEVEL *JOB FUNCTION * :
PERIOD * (DD/MM/YY DD/MM/YY)
JOB DESCRIPTIONS *
NO. OF SUBORDINATES
DIRECT REPORT TOPOSITION :
SALARY * Gross Net All In ALLOWANCE :
(Meals & Transportation)
OTHER BENEFITS
REASON FOR LEAVING
PREVIOUS POSITION
PERIOD
JOB DESCRIPTIONS
PREVIOUS POSITION
PERIOD
JOB DESCRIPTIONS
COMPANY NAME
COMPANY ADDRESS
INDUSTRY
COMPANY CATEGORY LOCAL PMA Joint Venture (Company Origin) :
LAST POSITIONEMPLOYMENT STATUS : Contract Permanent
POSITION LEVELJOB FUNCTION :
PERIOD(DD/MM/YY DD/MM/YY)
JOB DESCRIPTIONS
NO. OF SUBORDINATES
DIRECT REPORT TOPOSITION :
SALARY Gross Net All In ALLOWANCE :
(Meals & Transportation)
OTHER BENEFITS
REASON FOR LEAVING
PREVIOUS POSITION
PERIOD
JOB DESCRIPTIONS
PREVIOUS POSITION
PERIOD
JOB DESCRIPTIONS
COMPANY NAME
COMPANY ADDRESS
INDUSTRY
COMPANY CATEGORY LOCAL PMA Joint Venture (Company Origin) :
LAST POSITIONEMPLOYMENT STATUS : Contract Permanent
POSITION LEVELJOB FUNCTION :
PERIOD(DD/MM/YY DD/MM/YY)
JOB DESCRIPTIONS
NO. OF SUBORDINATES
DIRECT REPORT TOPOSITION :
SALARY Gross Net All In ALLOWANCE :
(Meals & Transportation)
OTHER BENEFITS
REASON FOR LEAVING
PREVIOUS POSITION
PERIOD
JOB DESCRIPTIONS
PREVIOUS POSITION
PERIOD
JOB DESCRIPTIONS
COMPANY NAME
COMPANY ADDRESS
INDUSTRY
COMPANY CATEGORY LOCAL PMA Joint Venture (Company Origin) :
LAST POSITIONEMPLOYMENT STATUS : Contract Permanent
POSITION LEVELJOB FUNCTION :
PERIOD(DD/MM/YY DD/MM/YY)
JOB DESCRIPTIONS
NO. OF SUBORDINATES
DIRECT REPORT TOPOSITION :
SALARY Gross Net All In ALLOWANCE :
(Meals & Transportation)
OTHER BENEFITS
REASON FOR LEAVING
PREVIOUS POSITION
PERIOD
JOB DESCRIPTIONS
PREVIOUS POSITION
PERIOD
JOB DESCRIPTIONS
What other agencies have you registered with? _________________________________________________
Declaration:Herewith I certify that the information given above is true to the best of my knowledge. I undertake to furnish any further information or documents required by the company in the processing of the application. Moreover, I do agree to follow all the conditions below:
a) I have / have never been convicted of any criminal charge.
b) I have / have never been taken and am presently not taking drugs.
c) I shall not conduct any direct transaction with the client introduced by PT. Selnajaya Prima unless instructed to do so.
d) I shall not provide any personal contact number to the client.
e) I shall be punctual and not be late or absent for the entire interview/test appointments. (Except with prior notice with acceptable reason).
f) I shall be neat and wear formal dress during the interview and working days.
g) I shall not forget to contact PT. Selnajaya Prima after I have been interviewed. Date: __________________
____________________ Signature of applicant
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