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PERSONAL_DATA_FORM_PT_SELNAJAYA_PRIMA_RECRUITMENT

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PERSONAL_DATA_FORM_PT_SELNAJAYA_PRIMA_RECRUITMENT Powered By Docstoc
					                                                         PT SELNAJAYA PRIMA
                                                                                th
                                                         MidPlaza I Building, 19 Floor

                                                         Jl. Jend. Sudirman Kav. 10 - 11 Jakarta 10220
                                                                                                                               Photo
   PERSONAL DATA                                         E-mail: recruitment@selnajaya.com

                                                         Url: www.selnajaya.com



I. PERSONALITY
 NAME                                                                                                    (M/F)

 PLACE / DATE OF BIRTH

 CONTACT ADDRESS



 E-MAIL

 TELEPHONE NUMBER                  *(M)                                         *(H)

                                                                                *(O)

 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                         □ 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)

             NAME                         RELATION                OCCUPATION / LOCATION                             PHONE
     III. EDUCATION, SEMINAR & LICENCES
      FORMAL EDUCATION (Last Education & High School)

               NAME of SCHOOL / PLACE                                 MAJOR                       PERIOD (YEAR)                   DEGREE**




      ** SMA/U, STM, SMEA, D1, D2, D3, D4, S1, S2, S3, etc.



      INFORMAL EDUCATION

               NAME of SCHOOL / PLACE                                 MAJOR                       PERIOD (YEAR)               CERTIFICATE




      ATTENDED SEMINAR

                   NAME of SEMINAR                           ORGANIZATION / PLACE                      PERIOD                 CERTIFICATE

                                                                                                  (MONTH / YEAR)




      CERTIFICATIONS

             ***NAME of CERTIFICATIONS                             ORGANIZATION / PLACE / YEAR                                    LEVEL




      *** Brevet A & B, CPA, CCNA, TOEFL, TOEIC, Japanese Proficiency Test, Etc



 IV. WORKING EXPERIENCE
      (Fill in the following form based on the number of job changes you’ve had, starting with your current or most recent job)

A.    COMPANY NAME

      COMPANY ADDRESS

      LINE OF BUSINESS

      COMPANY CATEGORY              □ LOCAL                      □ PMA (Company Origin) :

      LAST POSITION                                                                  EMPLOYMENT STATUS : □ Contract           □ Permanent

      PERIOD

      JOB DESCRIPTIONS




      NO. OF SUBORDINATES

      SUPERIOR

      SALARY                                                                             ALLOWANCE             :

                                   □ Gross    □ Net                                 (Meals & Transportation)
     OTHER BENEFITS

     REASON FOR LEAVING

     PREVIOUS POSITION

     PERIOD

     JOB DESCRIPTIONS




     PREVIOUS POSITION

     PERIOD

     JOB DESCRIPTIONS




B.   COMPANY NAME

     COMPANY ADDRESS

     LINE OF BUSINESS

     COMPANY CATEGORY      □ LOCAL           □ PMA (Company Origin) :

     LAST POSITION                                           EMPLOYMENT STATUS : □ Contract   □ Permanent

     PERIOD

     JOB DESCRIPTIONS




     NO. OF SUBORDINATES

     SUPERIOR

     SALARY                                                      ALLOWANCE              :

                           □ Gross   □ Net                   (Meals & Transportation)

     OTHER BENEFITS

     REASON FOR LEAVING

     PREVIOUS POSITION

     PERIOD

     JOB DESCRIPTIONS




     PREVIOUS POSITION

     PERIOD

     JOB DESCRIPTIONS
C.   COMPANY NAME

     COMPANY ADDRESS

     LINE OF BUSINESS

     COMPANY CATEGORY      □ LOCAL           □ PMA (Company Origin) :

     LAST POSITION                                           EMPLOYMENT STATUS : □ Contract   □ Permanent

     PERIOD

     JOB DESCRIPTIONS

     NO. OF SUBORDINATES

     SUPERIOR

     SALARY                                                      ALLOWANCE              :

                           □ Gross   □ Net                   (Meals & Transportation)

     OTHER BENEFITS

     REASON FOR LEAVING

     PREVIOUS POSITION

     PERIOD

     JOB DESCRIPTIONS




D.   COMPANY NAME

     COMPANY ADDRESS

     LINE OF BUSINESS

     COMPANY CATEGORY      □ LOCAL           □ PMA (Company Origin) :

     LAST POSITION                                           EMPLOYMENT STATUS : □ Contract   □ Permanent

     PERIOD

     JOB DESCRIPTIONS




     NO. OF SUBORDINATES

     SUPERIOR

     SALARY                                                      ALLOWANCE              :

                           □ Gross   □ Net                   (Meals & Transportation)

     OTHER BENEFITS

     REASON FOR LEAVING

     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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