Jakarta Plant

APPLICATION FORM
PERSONAL DATA Private & Confidential

Full Name :
Place / Date of Birth :
Sex : Male / Female Photo
Status : Single / Marriage / Widower / Widow 3X4
Residences (complete) :
:

: personal house parents house rental house

Telephone No. : Office : Ext. :
Home : ( )
HP :
E-mail :

EDUCATIONAL HISTORY
Years Attended Qualification
Name of School or College Town/City Department/Major Program of Study GPA
(S1/D4/D3)
From To

Consideration or Reason for Choosing the Department/Major in College:

Title of Thesis or Final Task:

WORKING EXPERIENCE (as fulltimer, parttimer, contract or apprentise)

Name, address & telephone of company Date Position
Starting Ending Starting Ending

Type of company : Main Job :

Salary :
Allowance :
Reason of leaving :

ACHIEVEMENT (Performance That You Ever Achieved)

1.

2.

3.

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Jakarta Plant

Private & Confidential

GENERAL INFORMATION (Give circle to the answer)
HEALTH
Have you ever suffered from chronic/serious illness If Yes, please describe it with shortly:

Yes No
or accident or surgery

Do you using eyeglasses Yes No

Do you have Colour Blind Yes No If Yes: Total / Half

If Yes, please describe it with shortly:

Do you have any allergic? Yes No
If Yes, please describe it with shortly:

Do you fear of heights or have any other phobia? Yes No

Height/Weight
…………cm / ……….kg
PERSONAL

Hobby or activity in the spare time

Strong Point (personality) Weak Point (personality)

1 1

2 2

3 3

4 4

5 5
ADDITIONAL
If Yes, as what and when?

Do you ever applied for in our company before? Yes No

Do you have family or friends who work in this If Yes, who:

Yes No
company?

Do you willing to work in Jakarta? Yes No

Do you willing to work on shift and in holiday? Yes No

On what date would you be able to commence

joint With our organization
Your monthly salary expectation is


(gross due to tax Pph21):

I certify that the above information is true and I agree the company taking disciplinary action against me if ny information is
found false and I allow the Company to do reference check

HR Department …………......………,Date…………Month…………Year……….
O-I Jakarta Plant
Jl. Raya Bekasi KM 24.5
Cakung - Jakarta 13960 (..............................................................)
Phone : 021-46951000 Name

Shoes Size:

Shirt Size:

Trousers Size :
Please fill this part to help us provide your safety equipment

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