FORMULIR LAMARAN KERJA

Employment Application Form

Posisi yang dilamar Position applied
_____________________

Pas foto/
Place
photo here

Tanggal Date

1. ______________________________
2. ______________________________
DATA PRIBADI PERSONAL DATA
Nama lengkap __________________________

Laki-laki

Full name
Tempat/tanggal lahir _____________________
Place/date of birth
Status perkawinan _______________________
Marital status
Agama _________________________________
____________________
Religion

Perempuan

Male
Female
Warganegara ______________________
Nationality
Menikah sejak _____________________
Married since
Golongan darah
Blood type

ALAMAT ADDRESS
Alamat Tetap Permanent Address
_______________________________________

Alamat Surat Mailing Address

_________________________________

_______________________________________

_________________________________

Kota/Propinsi ___________________________
City/Province
Kode pos ______________________________
Postal code
No. Telepon/HP _________________________
Phone/Mobile
E-mail _________________________________
____________________________

Kota/Propinsi ______________________
City/Province
Kode pos _________________________
Postal code
No. Telepon/HP ____________________
Phone/Mobile
E-mail

PENDIDIKAN FORMAL FORMAL EDUCATION

Jenis Sekolah*
Type of school*

Nama Sekolah
Name of
institute

Kota
City

Jurusan
Major

Tahun Lulus
Year of
graduate

*Jenis sekolah: SD/SMP/SMA/SMEA/SMK/Diploma/Akademi/Institut/Universitas

* Type of school: Elementary Sch/Junior High Sch/Senior High
Sch/Diploma/Institute/University

DATA IDENTITAS IDENTITY DATA

No. KTP _______________________________
Tanggal dikeluarkan______________
ID Card number
_______________________________
_______________________________________Date of issued
Dikeluarkan oleh______________________
Berlaku sampai __________________
Issued by
______________________________
_______________________________________Valid until
Jenis SIM______________________________
No. SIM__________________________
Driving license type
_______________________________________SIM number
Tgl. Dikeluarkan_______________________
Berlaku sampai __________________
Date of issued
_______________________________________Valid until
DATA KELUARGA FAMILY DATA
Hubungan *

Nama Lengkap

Tempat/Tgl. Lahir

Pekerjaan

Relationship
*

Full name

Place/DOB

Occupation

Warga
Negara
Nationality

*Hubungan: Kakek/Nenek/Ayah/Ibu/Mertua/Suami/Istri/Kakak/Adik/Anak
Diisi hanya data keluarga yang masih hidup, dimulai dari yang paling tua, misal:
Kakek, nenek, dll.. Apabila jumlah keluarga melebihi jumlah baris yang tersedia,
silahkan ditulis di halaman belakang.
*Relationship: Grandfather/Grandmother/Father/Mother/Father-Mother in
law/Spouse/Siblings/Child
Please fill with the data of your existing family, starting from the oldest one,
e.g. grandfather etc.. If you need more space, please use an extra page.

PELATIHAN TRAINING
Nama/Jenis Pelatihan
Name/Type of training

Penyelenggara/Lokasi
Organizer/Location

Bulan/Tahu
n
Month/Year

PENGALAMAN KERJA WORKING EXPERIENCE

Perusahaa
n
Company

Jenis Usaha
Bussines
type

Kota/Nega
ra
City/Coun
try

Periode
(Thn)
Period
(year)

Departem
en
Departme
nt

Bagian
Section

Jabatan
Position

Gaji
Salary

Alasan berhenti
Reason of leaving

Gaji yang diharapakan ___________

Masa tunggu untuk pemberitahuan_____________
Tgl. Bisa mulai bekerja
________________________________________________________
Expected Salary ___________
Notice period
Available date
REFERENSI REFERENCE
Nama
Name

Telepon
Phone

Perusahaan
Company

Departemen
Department

Jabatan
Position

Hubungan
Relationship

LAIN-LAIN OTHERS
Apa yang saudara ketahui tentang Argo Manunggal Group?
What do you know about Argo Manunggal Group?
________________________________________________________________________________________
________________________________________________________________________________________
Apa yang saudara harapkan dari perusahaan kami bila anda diterima bekerja?
What do you expect from our company if you are employed?
________________________________________________________________________________________
________________________________________________________________________________________
Apakah saudara bersedia bekerja di luar daerah/pulau?
Are you willing to work in another province/island?
________________________________________________________________________________________
Apakah saudara pernah mengalami penyakit serius? Jika pernah, kapan?
Have you ever suffered from a serious illness? When?
________________________________________________________________________________________
Apakah saudara mempunyai kerabat/keluarga yang bekerja di perusahaan-perusahaan
milik Argo Manunggal Group? Jika ya, sebutkan.
Do you have any relatives who are currently working for companies in Argo Manunggal
Group? If yes, please mention.
________________________________________________________________________________________

Dengan ini, saya menyatakan bahwa data di atas ditulis dengan benar. Apabila dalam
masa kerja nanti diketahui bahwa data tersebut tidak benar/dipalsukan, maka Perusahaan
dapat memutuskan hubungan kerja tanpa harus membayar uang pesangon/jasa maupun
ganti rugi dalam bentuk apapun.
I hereby certified that information provided herein is true to the best of my knowledge. In
the event of employment, I understand that false or misleading information provided in
my application may result in termination of my employment without receiving
severance/service pay and/or compensation of any kind.

__________________________________
Nama & Tanda tangan pelamar
Name & Signature of applicant