FM-HRD-REC-04

ASEAN Secretariat Jl. Sisingamangaraja 70A Jakarta 12011

A((i7 P)otograp) 8ere #cop. and paste%

EMPLOYMENT APPLICATION FORM

Position applied : _________________________ Application Source: ASEA !e"site #!!!.asean.org$opportunities% &nline ad'ertisement #(rom ot)er !e"site% Print ad'ertisement &t)ers: ____________________________________ Date: ___________________________

I.PERSONAL ame : ____________________________________________ email address : _________________________ *ast ame +irst ame ,iddle ame Present Address : __________________________________________________________________________________________ Street -it. -ountr. /ip -ode 0elep)one : _______________ #o((ice% _______________ #residence% ___________________ #)and p)one% Date$mont)$.ear o( 1irt) : _________________ Place o( 1irt) : __________________ 2ender :________________________ ,arital Status : Single ,arried 6ido!#er% -iti3ens)ip : _________________ 4denti(ication -ard 50P$Passport % o.: ________________________ Place o( issue : _______________ 4ssued ". : _____________________ 4ssued date : ____________________ E7piration date : __________________

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II. FAMILY BACKGROUND a. Parents Name Relati ns!i" +at)er ,ot)er &. Famil' ( De"en$ent Name Relati ns!i" Date O# Birt! E$%cati n Occ%"ati n

Se)

Date # &irt!

E$%cati n

Occ%"ati n

III. FORMAL EDUCATION Years atten$e$ Name # Sc! Start En$in+ l L cati n Ma* r De+ree +rante$ Main S%&*ects

I,. EMPLOYMENT RECORD -Start #r m t!e m st recent. 1. 9ears emplo.ed$duration +rom 0o ame o( &rganisation $ -ompan. Address$P)one Position et Salar. per annum #E7cluding allo!ances% Starting +inal

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Description o( .our !ork :

:eason (or lea'ing :

Super'isor;s ame : 0elep)one : ame o( &rganisation $ -ompan. Address$P)one Position et Salar. per annum #E7cluding allo!ances% Starting +inal

2. 9ears emplo.ed$duration +rom 0o

Description o( .our !ork:

:eason (or lea'ing : <. 9ears emplo.ed$duration +rom 0o ame o( &rganisation $ -ompan.

Super'isor;s ame : 0elep)one : Address$P)one Position et Salar. per annum #E7cluding allo!ances% Starting +inal

Description o( .our !ork :

:eason (or lea'ing : 0otal !orking e7perience : __________ .ears

Super'isor;s ame : 0elep)one : Salar. e7pectation : __________________

Please note t)at in e'aluating .our candidature ASEA Secretariat reser'ed t)e rig)t to approac) .our pre'ious emplo.er#s% (or re(erences. 4t is not our polic. to approac) .our present emplo.er at t)e e'aluation stage unless .ou e7pressl. aut)ori3e t)is. 8a'e .ou an. o"jections to our making in=uiries o( .our present emplo.er> 9es o

Please note? )o!e'er? t)at "e(ore making an o((er o( emplo.ment ASEA Secretariat is re=uired to contact "ot) .our present and pre'ious emplo.ers. _______________________________________________________________________________________________ ,. SKILLS Remar/s -omputer ,A4 0E A -E
#(or computer related position%

P-

*A

So(t!ares : *anguage +air Speak 2ood +luent +air :ead $6rite 2ood +luent

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&t)er ,I. COURSE ( TRAINING RECORD -erti(ication$Seminar$-ourse Description$0.pe &n t)e Jo" 0raining$0raining

4nstitution

Place$*ocation

Duration

8a'e .ou "een c)arged (or committing to an. crime> 4( .es? please e7plain.

Are .ou a mem"er o( la"our organi3ation or political part.> 4( .es? please state t)e name? address and .our position in t)e organi3ation.

Emplo.ment ". t)e ASEA Secretariat ma. re=uire assignment and tra'el to an. area. 8a'e .ou an. disa"ilities or reser'ations t)at ma. restrict .our acti'ities in t)is respect> 4( .es? please e7plain. Are .ou under an. o"ligation to return$sta. in t)e ser'ice o( .our compan. in recognition o( sponsored training or education> Please s)o! .our position at .our current jo" in an organi3ation c)art.

9es

9es

4( t)is space not enoug)? please use ne7t page. Please menti n t!ree -0. re#erences N . Name Occ%"ati n A$$ress 1 Email Tele"! ne

4 )ere". certi(. t)at t)e a"o'e in(ormation is true and correct. 4 agree t)at an. misinterpretation made in t)is application (or t)e purpose o( securing emplo.ment s)all "e grounds (or termination or denial o( emplo.ment. +inal appointment !ill "e su"ject to a p).sical e7amination.

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Applicant;s Signature : ___________________________