PT SELNAJAYA PRIMA

MidPlaza I Building, 19th Floor

Jl. Jend. Sudirman Kav. 10 - 11 Jakarta 10220

PERSONAL DATA

E-mail: recruitment@selnajaya.com

Photo

Url: www.selnajayarecruitment.com

a. PERSONALITY
FULL NAME *

(M/F)

PLACE / DATE OF BIRTH *

CONTACT ADDRESS
E-MAIL *
TELEPHONE NUMBER *

*(Mobile)

*(Home)
*(Emergency)

EMERGENCY CONTACT NO.

STATUS

Married

Single

OCCUPATION

Divorced / Widowed
/ (Present position)

JOB APPLICATION
IDENTITY NUMBER
DRIVER LICENCE

A / B1 / B2 / C

OWN VEHICLE

NATIONALITY

ETHNICITY

BLOOD TYPE

RELIGION

CHARACTER

HOBBIES

COMPUTER SKILLS

OTHER SKILLS

LANGUAGES ABILITY

English

EXPECTING SALARY (THP)

Rp

Japanese

Indonesian

Mandarin
(Gross/Net)

Yes No

Car / Motorcycle

Others (..)
Negotiable

Allowances :
AVAILABILITY
EXPECTING LOCATION
Your wishes / expectations / notes towards your new job :
* Required Fields (H: Home, M: Mobile, O: Office)

B. LIST OF REFERENCES
(Your professional contact references for recommendation)
NAME

RELATION

OCCUPATION / LOCATION

PHONE

c. EDUCATION, SEMINAR & LICENCES

FORMAL EDUCATION (Last Education & High School)
NAME of SCHOOL / PLACE

MAJOR

PERIOD *

DEGREE**

GRADUATE

START - END

(Y/N)

(DD/MM/YY DD/MM/YY)

** SMA/U, STM, SMEA, D1, D2, D3, D4, S1, S2, S3, etc.
INFORMAL EDUCATION
NAME of SCHOOL / PLACE

MAJOR

PERIOD *

CERTIFICATE

GRADUATE

(YEAR)

(Y/N)

ATTENDED SEMINAR
NAME of SEMINAR

ORGANIZATION / PLACE

PERIOD *

CERTIFICATE

(YEAR)

(Y/N)

CERTIFICATIONS
***NAME of CERTIFICATIONS

ORGANIZATION / PLACE / YEAR

LEVEL

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

d. WORKING EXPERIENCE
(Fill in the following form based on the number of job changes youve had, starting with your current or most recent job)
A.

COMPANY NAME *
COMPANY ADDRESS *
INDUSTRY *
COMPANY CATEGORY

LOCAL

PMA

Joint Venture

(Company Origin) :

LAST POSITION *

EMPLOYMENT STATUS : Contract

POSITION LEVEL *

JOB FUNCTION * :

PERIOD *
(DD/MM/YY DD/MM/YY)
JOB DESCRIPTIONS *

NO. OF SUBORDINATES
DIRECT REPORT TO

POSITION

SALARY *

ALLOWANCE :
Gross

OTHER BENEFITS
REASON FOR LEAVING
PREVIOUS POSITION
PERIOD
JOB DESCRIPTIONS

PREVIOUS POSITION
PERIOD

Net

All In

(Meals & Transportation)

Permanent

JOB DESCRIPTIONS

B.

COMPANY NAME
COMPANY ADDRESS
INDUSTRY
COMPANY CATEGORY

LOCAL

PMA

Joint Venture

(Company Origin) :

LAST POSITION

EMPLOYMENT STATUS : Contract

POSITION LEVEL

JOB FUNCTION :

Permanent

PERIOD
(DD/MM/YY DD/MM/YY)
JOB DESCRIPTIONS

NO. OF SUBORDINATES
DIRECT REPORT TO

POSITION

SALARY

ALLOWANCE :
Gross

Net

(Meals & Transportation)

All In

OTHER BENEFITS
REASON FOR LEAVING
PREVIOUS POSITION
PERIOD
JOB DESCRIPTIONS

PREVIOUS POSITION
PERIOD
JOB DESCRIPTIONS

C.

COMPANY NAME
COMPANY ADDRESS
INDUSTRY
COMPANY CATEGORY

LOCAL

PMA

Joint Venture

(Company Origin) :

LAST POSITION

EMPLOYMENT STATUS : Contract

POSITION LEVEL

JOB FUNCTION :

PERIOD
(DD/MM/YY DD/MM/YY)
JOB DESCRIPTIONS

NO. OF SUBORDINATES
DIRECT REPORT TO

POSITION

SALARY

ALLOWANCE :
Gross

OTHER BENEFITS
REASON FOR LEAVING
PREVIOUS POSITION
PERIOD

Net

All In

(Meals & Transportation)

Permanent

JOB DESCRIPTIONS

PREVIOUS POSITION
PERIOD
JOB DESCRIPTIONS

D.

COMPANY NAME
COMPANY ADDRESS
INDUSTRY
COMPANY CATEGORY

LOCAL

PMA

Joint Venture

(Company Origin) :

LAST POSITION

EMPLOYMENT STATUS : Contract

POSITION LEVEL

JOB FUNCTION :

Permanent

PERIOD
(DD/MM/YY DD/MM/YY)
JOB DESCRIPTIONS

NO. OF SUBORDINATES
DIRECT REPORT TO

POSITION

SALARY

ALLOWANCE :
Gross

Net

All In

(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)
c)

I have / have never been taken and am presently not taking drugs.
I shall not conduct any direct transaction with the client introduced by PT. Selnajaya Prima unless instructed to do so.

d)
e)

I shall not provide any personal contact number to the client.

I shall be punctual and not be late or absent for the entire interview/test appointments. (Except with prior notice with acceptable reason).

f)
g)

I shall be neat and wear formal dress during the interview and working days.
I shall not forget to contact PT. Selnajaya Prima after I have been interviewed.

Date: __________________

____________________
Signature of applicant