APPLICATION FOR EMPLOYMENT

POSITION APPLIED FOR: ___________________________________________________

(Please fill up in English)
PERSONAL PARTICULARS
Name
Ario Wibisono

Permanent Address
(Parents’ address) Mutiara Kebagusan Residence Kav. A-5
_______________________________________________________________________________
Jl. Kebagusan IV - Pasar Minggu
_______________________________________________________________________________

Phone Number (must fill): Home 021 78841930

:__________________________________________________
08121222746
Mobile :__________________________________________________
Foreign Address
(Dormitory / Rental House _______________________________________________________________________________
address)
_______________________________________________________________________________

Phone Number : __________________________________________________

Email Address ario.wibisono@gmai.com

Date of Birth 30 September 1973 Citizenship: Indonesia

Age 38 Sex : Male

Identity Card No : 3174043009730003
Place of Birth Jakarta Please write the number

Race Javanese Social Security No.:

Moslem
Religion Income Tax No.:

Language Spoken Bahasa Passport No.: 7072F Type:

(including Dialect) English

Bahasa Feb 2015

Language Written English
Passport Expiry Date:

FAMILY DETAILS (Include yourself)

Parents’/ Siblings’ Full Name Relationship Occupation Company/Institution Name

Father (the LATE) IR. Suyuwono

Mother (the LATE) ISumiaty Suyuwono

1. Rikma Aprianti Wife Private Employees Banking industries

2. Akira Kanishka Son

3. Dinara Kheista Kukila Daughter

4.

5.

(*) Please delete whichever not applicable.

 Marital Status: Single / Married / Divorced / Separated / Widowed (*)
If Married, please provide spouse’s and children’s details below:

Spouse’s Name Date of Birth Occupation Company Name

Children’s Name Date of Birth Occupation Company/Institution Name

In case of emergency, please contact : (must fill)

Name Relationship Address Telephone No.

EDUCATIONAL DETAILS
School / Institution Date Date Highest Standard
City/Country Joined Graduated Passed
Name (Grade / Degree)
Elementary

Jr. High

Senior High

Diploma

University

Others

Other Academic or Professional Qualifications (including Training Courses attended):

Particulars Year
From To

Details of Education or Training presently pursuing:

Commencement Expected Date of
Particulars Date Completion

PROFESSIONAL MEMBERSHIP
Name of Professional Body Membership Position Date Admitted

(*) Please delete whichever not applicable. 2

 EMPLOYMENT
EMPLOYMENT HISTORY

PAST EMPLOYMENT
Last
Year
Company Drawn Allowance Reason(s) for Leaving
Position Held
Salary (if any)
From To

PRESENT EMPLOYMENT

Company Employed Position Current Allowance (if Reason(s) for Wanting to

since Salary any) Leave

Indicate past / present duties and responsibilities relevant to position applied for :

Have you any objections to reference being made to your

(a) Past Employers Yes Present Employers Yes / No *
/ No *

If you are successful in this application:

What is the length of notice required If appointed, what is your expected GROSS salary (gross= plus income tax &
to terminate your present employment: 2% Jamsostek contribution) ?
Rp. __________________

Negotiable / Fixed (*)

(*) Please delete whichever not applicable. 3

CHARACTER REFEREES (Family members / relatives should not be used)
Full Name : Full Name :

Address & Phone Number Address & Phone Number

Company Name: Company Name:

Occupation : Occupation :

Relation with you : Relation with you :

HEALTH DECLARATION
Have you suffered from any disease, ailment, injury or any other medical/psychological conditions in the past
that required treatment, hospitalization and or surgery?

Yes / No (*)

If yes, please specify:

_____________________________________________________________________________________
_____________________________________________________________________________________

Are you currently undergoing any medical/psychological treatment, medication or medical follow-up?

Yes / No (*)

If yes, please specify:

_____________________________________________________________________________________
_____________________________________________________________________________________

Do you smoke?

Yes / No (*)

If yes, please indicate accordingly: [ ] social smoker [ ] habitual smoker [ ] chain smoker

Have you been under medical treatment regarding with drugs and/or psychotropic medicine?

Yes / No (*)

If yes, please specify:

_____________________________________________________________________________________
_____________________________________________________________________________________

Have you suffered from any trauma attack?

Yes / No (*)

If yes, please specify:

_____________________________________________________________________________________
_____________________________________________________________________________________

(*) Please delete whichever not applicable. 4

 OTHER INFORMATION
Are you a member of any union? Yes / No (*)

If yes, please specify: ______________________________________________________________________________

Have you been convicted in a court of law? Yes / No (*)

If yes, please specify: ______________________________________________________________________________

Have you ever taken part in any Psychological test ? Yes / No (*)

If yes, please mention :

Date/year of Psychological test conducted ______________________________________________________________

Purpose of the Psychological test _____________________________________________________________________

For Female Only

Are you presently expecting a child? Yes / No *

For Singaporean Male Only

Have you served your National Service liability? Yes / No *

If you have been exempted, state reason: ______________________________________________________________

If you have served NS, please complete the following:

Vocation in the Army: Rank: Unit: Period of Service:
From To
Mobilisation Code Name: Next In-camp Training
Due Date :

ANSWER THE QUESTIONS BELOW

1. Tell us about yourself!

2. What are your hobbies?

3. What is your biggest weakness Strength :

and strengths?

Weakness :

4. Why do you want this job?

(*) Please delete whichever not applicable. 5

 5. Why should Oberthur
Technologies hire you?

6. Where do you want to be in five

years’ time?

7. Why are you leaving your current

role?

8. Please explain your best The best achievements :

achievement and failure in job!

The worst failure :

9. Explain a situation where you have What were the situations?

to handle big pressure!

What were your actions?

What were the results of your action?

I declare that the information given in this form is true and correct. Any false or misrepresented information will render my
application null and void; and if employed, I agree that my appointment shall be terminated.

_________________________ ______________________________
Date Signature of Applicant

(*) Please delete whichever not applicable. 6