Application Form

For employment with PIAGET ACADEMY SCHOOLS

Please complete all pages of this form fully and accurately where relevant. If there is not enough
space, you may attach further details on a separate sheet. All applications will be treated in
confidence. Please type or complete in BLOCK letters.

Title of job applied for : Teacher Librarian

Teaching Subject/Level : Librarian Teacher
Date available for employment: May 2020__ Salary expected: USD 1250$ or
17,500,000 IDR____
Name in English: Akhmad Khaerul Fikri
Name in Chinese (if applicable): ___________________
Date of Birth: May 24, 1988 Sex: □ Male □ Female
Nationality: Indonesia_______________ Passport No: ____________________
Email Address : khaerul.fikri2405@gmail.com
Contact Telephone No : +6281585396329 / +6287881703004 / +6281908627284 /
Skype ID : khaerul.fikri2405@gmail.com

ACADEMIC ATTAINMENT (in chronological order)

From To Name of school/university Qualification obtained (incl. subject

specialisation)
2006 2009 University of Indonesia, Diploma in Document Management &
Indonesia Information (special subject in Library
science & Record Management)
2003 2006 National High School 02 – Social Science
Bekasi, West Java. Indonesia
2000 2003 National Middle School – Al Social Science
Ghifari – Sukabumi, West Java.
Indonesia
PROFESSIONAL QUALIFICATION (in chronological order)

From To Name of Qualification / Teaching Licence

school/university/authority

FULL EMPLOYMENT RECORD (in chronological order)

Fro To Name of Position held Reason for Leaving

m school/organisation
2018 Now HHR Lawyers Jakarta – Know How Manager
Indonesia
2015 2017 Regality Academy Head of Library & change in career
Jakarta, Indonesia Teacher Librarian direction.

2011 2015 ACG International School Head of Library & looking for better
Jakarta, Indonesia Teacher Librarian career prospects,
professional growth
2010 2011 Singapores International Head of Library looking for new
School - Kelapa Gading, challenges at work
Jakarta, Indonesia
2009 2010 Metro TV Jakarta, Document Media Have other life goals
Indonesia Controller that I want to
accomplish

Last drawn salary (per annum): Rp, 168.000.000 (IDR)

CO-CURRICULAR ACTIVITIES RECORD (in chronological order)

Please list the activities/sports/clubs you helped to coach/manage in your previous
organizations/schools

From To Name of Activites/Sports/Clubs Position Held (eg

school/organisation coach)
2018 Now SLIMS (Librarian Develop library systems Member
Community in IT for better purposes
developing program)
2019 Now Story Teller Community Telling story to the Member
people in need i.e kids,
orphanage, or attend
event.
2015 201 Regality Academy Movie Editor for primary Editor Supervisor
7 Jakarta, Indonesia level – Middle School
2011 201 ACG School Jakarta Drama teacher for Director
5 primary level

GENERAL BACKGROUND INFORMATION

You must give complete answers to all questions. If you answer “Yes” to any question, give
a brief outline of the issue process and the update or outcome on a separate sheet of paper.

Yes No
1. Were you ever convicted of a criminal offence? V
2. Are you currently under charges and/or investigation for a criminal V
offence?
3. Have you ever previously been refused registration as a teacher, or V
ever been refused permission to teach, or having been so registered or
given permission and yet had the registration or permission cancelled ?
4. Have you ever been disciplined, discharged, or asked to resign from a V
prior position?
5. Have you ever resigned from a prior position after a complaint had V
been received against you or your conduct was under investigation or
review?
6. Has your contract in a prior position ever been non-renewed? V
7. Have you ever been charged with or investigated for sexual abuse or V
harassment or another person?
8. Has someone ever accused you of assaulting/or abusing a child? V

Medical Details
Any current or past medical condition(s) which may affect your teaching responsibilities? If yes,
please provide details.
NO
Any current or past medical condition(s) which requires/required regular treatment? If yes,
please provide details.
NO

REFERENCES
We may seek confidential reference on you once you are shortlisted for further
consideration. Please provide details of two referees (preferably your former academic
adviser/job supervisor) whom we can invite to comment on your academic / professional
suitability for the post:
Name: _Tetty Rustika_______________________ Position: HR Manager__________
Organisation/School: Regality Academy
Address: Kuingan, Sout Jakarta – Indonesia
Telephone : (+6221) 22083160 / +62-811-8899-400
Email: hrd.ra@royalacademy.sch.id

Name: Herri Kurniawan Position: Head of Library/Teacher Librarian

Organisation/School : ACG School Jakarta
Address : Jati Padang, Pasar Minggu - South Jakarta, Indonesia
Telephone: +62-21-2978 0200
Email: heri.kurniawan07@gmail.com

If you are offered an appointment, we will approach your employer to confirm details of
your present/last employment. Please provide the particulars of the contact person of your
*present/last employer below:
PARTICULARS OF SPOUSE & CHILDREN

Name Relationship Citizenship Occupation

Nila R Megasari Wife Indonesia School Teacher

Arsyla Zakia Akhmad Daughter Indonesia 4 years old

Mecca Medina Akhmad Daughter Indonesia Still Baby 11 Mo

PASSIONS

What are your passions?

Kids and books are the best thing about being a librarian. From that I can explore many ways to
serve children as an educator. Also I want to change their mind set about library is a boring
place, I want them to know the library is fun place to study and find inspiration
most people don’t know what others do unless they’ve done it and that is what do most people
not know about the great work of a librarian, especially teacher librarian.
I'm passionate about making a difference. When I'm involved with a project at work, I want to
do my best to achieve success. I feel the same way about what I do in my personal life.
ASPIRATIONS

What are your aspirations? (in the short term, eg 3 years and in the long run)
1. Gain experience in a leadership role
2. Be the best parent to your kids
3. Travel to 5 different places for leisure

FUTURE ROLES

If you are accepted, what other roles other than teaching do you wish to fulfil and how do you
plan to achieve them?
I will use my skills as Drama director and movie editor. If the school can give me a chance to fill
any an extracurricular that related to them I will do it.

STRENGTHS AND WEAKNESSES

Highlight your strengths and weaknesses and any areas you wish to improve
Strengths:
“I’m a problem solver. I love taking a problem and looking at it from every angle. I enjoy work
that challenges me and pushes me to think outside the box. I enjoy situations where I am
allowed to work with other people to come up with creative solutions. And also I’m ability to
learn from mistakes, creative thinking, discipline and determination, communication skills,
dedication and enthusiasm
Weakness & improvement :
I hate confrontation and in the past found myself at times compromising what I wanted or
needed in order to keep the peace. This was a real problem, especially in team situations or
when I was supposed to be leading a group because there are times when you need to tell
people things they might not necessarily want to hear. Since then I’ve realized this is a weakness
of mine and I’ve worked very hard to overcome it. Now instead of avoiding those situations, I
take it as an opportunity to practice being more assertive without coming across as difficult. I
take the time to listen to each side of the situation and make sure that if I have any comments
or criticisms that they are constructive and that the solutions I offer are actual solutions and not
just “peace patches.”
MENTORSHIP EXPERIENCES

Highlight any experiences you have in being an inspiring mentor

I’ve been able to pass on my knowledge and experience while learning about others. As a
mentee I’ve received invaluable insight into all aspects of work and life.
In my opinion, done right, the mentoring process is one of the best ways to learn and develop
and can be the difference between making or breaking. But it’s a process of cross-cultivation
and is far from one-way learning.

DECLARATION
I declare that the information on this form is true and accurate to the best of my knowledge
and belief, and that I have not withheld any information as to my suitability for employment
as a teacher.
I understand that providing incomplete or misleading or false information will disqualify me
from appointment or may lead to me being dismissed if appointed to the job.
My name has not been placed on any list which disqualifies me from working with children.
I consent to the School making any necessary enquiries for purposes relating to recruitment
and for the verification of the information given above.

Akhmad Khaerul Fikri January 30, 2020

____________________ _____________________
Signature of Applicant Date