EMPLOYMENT APPLICATION FORM

ADVICE This application will be kept strictly confidential; thus, please fill in complete information.

Put N/A where it's not applicable; if you write in English, please use capital letters. Photograph

Position Applied for : Engineering Supervisior Expected Salary Only Rp. 5.000.000

Your heard of this position from Internet

PERSONAL DATA

Name : Mr./Mrs./Ms. Natanael Tatengkeng Surname Nathan

Present Address Lingkungan II, Kel.Pandu, Kec.Bunaken Darat Kota Manado

Tel. 081242688482

E-mail address nathantatengkeng@gmail.com Age 35 Years Height 168 cms. Weight 58 kgs.

Date of Birth 03 September 1985 Place of Birth Manado

Nationality Indonesia Religion Kristen Protestan

ID. Card No./Passport No. 7171080309850001

Issued by Expiry Date Lifetime

Marital Status Single Married Separated Widowed Divorced

Spouse's Name Elfira Mundaeng Age 33 Occupation / Firm Ibu Rumah Tangga

Address / Tel. Lingkungan II, Kel.Pandu, Kec.Bunaken Darat Kota Manado

Number of Independenys: 2

Please give Name, Age, Sex of each. Natasya Imanuella Tatengkeng 14 years Female

Josua Engelbert Tatengkeng 10 years Male

FAMILY PARTICULARS
Father's Name Taka Tatengkeng Age Occupation

Mother's Name Melfa Datunsolang Age Occupation

Number of Brothers (ชาย) 2 Brother Billy Tatengkeng

 EDUCATION RECORD

Educational Level Name and Address of School/College From-To-Year Certificate Major

Primary SDN 18 jakarta selatan 1998

Secondary SLTP N 9 manado 2001

Vocational SMK EL FATAH Manado [elektronika komunikasi] 2004

University

Others

MAJOR TRAINING COURSES OR SEMINAR ATTENDED

Course/Topic Institute of Organizer Date of Training Certificate Obtained

PROFICIENCY IN LANGUAGE
Please tick "√" where applicable.

Speak Read Write

Languages
Good Fair Poor Good Fair Poor Good Fair Poor

English

French

Japanese

indonesia

OTHER SKILLS

Typing Chinese wpm English wpm Fax Operation

Computer Program : Word Excel Power Point Pagemaker Other…………..

 EMPLOYMENT RECORD

Please list all employments, starting with present or most recent job.

Employment Date
Company's Name and Address Position Held Final Salary Reason for leaving
From To
Jan 2007 - Okt 2007 CV.Karya Teknik Teknisi

Jan 2008 - Okt 2008 Amara Bela Internasional Hotel Ternate Staff Engineering

May 2009 - Okt 2012 Aston Manado Hotel Staff Engineering

Nov 2012 - Juli 2014 CV.A L Manadiri Senior Engineering

July 2014 - Mar 2015 Cantika Swara Resort Berau Senior SPV Engineering

Jan 2016 - Jan 2017 Best Western The Lagoon Manado Engineering General Maintenance

Mar 2017 - Now Four Point By Sheraton Manado Senior Engineering General Maintanace

Can we contact your employer (s)? Yes No

Are you self employed? Yes No

HEALTH

Have you had any serious illness or injury durin the past 5 years? Yes No

If YES, please describe :

Do you have any physical handicaps, chronic diseases, or other disabilities? Yes No

If YES, please describe :

MISCELLANEOUS

Ability to drive a vehicle Car Motobike Other

Driving license (if any) : Type of vehicle

Kind Yearly Permanent License No.

Your interest in social and recreational activities

Club or association you are a member of

1 2 3 4

Your hobbies : otomotif modifikasion

Have you joined the military service? Yes No Exempted

Have you ever charged or convicted of any criminal offence against the law?

Yes No If YES, describe Date, Charge, and Verdict.

Nature of Offence

Please list relatives or friends currently employed in this Company (if any).

Name Position Relationship

1 Jefrry Tumbelaka Chief Engineering

2 Geston Amarala Human Resources Manager

Person to contact in case of emergency :

Name elfira debora mundaeng Relationship

Address pandu lingkungan II kecamatan bunaken kota manado Tel. ###

Persons of Reference (Not a relative; former supervisors are preferable)

Name Work Place Position

1 jefrry tumbelaka engineering independent chief engineering

2 geston amarala four point sheraton manado heman resousces manager

If you are accepted, what is your notice period 30 days after being accepted Days

I certify that all information given in this application is true and complete to to the best of my knowledge. I understand that wilful misrepresentation,

false statements or omission of facts will be adequate ground for dismissal.

Applicant's Signature natanael tatengkeng Date 07 oktober 2019

 INTERVIEW ASSESSMENT

PART 1 : INTERVIEW BY HR DEPARTMENT

Descriptions Excellent Good Fair Poor Remarks

1 Personal & Appearance

2 English skills

3 Academic Achievement

4 Occupational Experience

5 Atitude

6 Initiative

7 Self Confidence

Overall Comment

Result To Div./Dept. Head for Final Interview To Keep in waiting list To regret

Position applied for Department

Interviewer Date
 PART 2 : INTERVIEW BY DEPT. AND/OR DIV. HEADS CONCERNED
Descriptions Excellent Good Fair Poor Remarks

1 Skills/Job Related Experience

2 Education

3 Communication Skills

4 Attitude

5 Quality Customer Service Skills

6 Self - Confidence

7 Appearance

8 Suitability For This Position

Comment

To hire To keep on file To regret

Dept. Head's Signature Date

Div. Head's Signature Date

PART 3 : TO BE COMPLETED BY HUMAN RESOURCES DEPARTMENT

Position Level Salary Date of Employment

Mgr./Dir. Of Human Resources Date

PART 4 : TO BE ACKNOWLEDGE BY EAM / GM

Executive Assistant Manager / General Manger Date