PANDU ANUGERAH ANALITIKA HOLDING COMPANY

HeadQuater Building, Tamini Interchange

Jl. Raya Pondok Gede No. 5 Dukuh Kramatjati Jakarta - Indonesia
Application
Tel: +62 21 80878498 Form

APPLICATION FORM

Interest Position 1. Product Specialist Reference No. : ……………………………………………..

2. ……………………………… Date : 19 April 2021

I. PERSONAL DATA

Full Name : Rana Puti Lembayu Nick name Rana

Gender Female
Address Jl. Singa Harau, Kel. Balai Panjang, Kec. Payakumbuh Selatan

Zip Code 26226

Telephone Home: - HP: 82258939916 Office: -
Place/Date of Bird Payakumbuh
Religion Moeslim
Marital Status Single Children: -
ID No. 1376015608970000
Insurance No. -

II. EDUCATIONAL BACKGROUND

Education Institution Name City Major GPA Graduate on

Elementary SD N 49 Payakumbuh Payakumbuh - - 2010
Junior High SMP N 1 Payakumbuh Payakumbuh - - 2013
Senior High SMA N 2 Payakumbuh Payakumbuh IPA - 2016
Academic/Univ. Universitas Gadjah Mada Yogyakarta Biology 3.26 2020
Master

III. COURSE/OTHERS

Activity Administrator Year Period Certificate No.

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PANDU ANUGERAH ANALITIKA HOLDING COMPANY
HeadQuater Building, Tamini Interchange
Jl. Raya Pondok Gede No. 5 Dukuh Kramatjati Jakarta - Indonesia
Application
Tel: +62 21 80878498 Form
IV. EDUCATIONAL INFORMATION

1 Achievement during your education (example: top rank, cum-laude, etc)

a………………………………………………………………………………………… Year ………………………
b………………………………………………………………………………………… Year ………………………
c………………………………………………………………………………………… Year ………………………

2 Who is the sponsor of your education cost? Bidikmisi Program of Ristekdikti

………………………………………………………………………………………………………………………………
3 Paper/Journal that has been published: ……………………………………….
1. Phenotypic characteristic of excotic-broiler, kampung, male-excotic layer, KUB-1 and pelung chicken

2. The potential utilization of jawa super hen eggs as people's food security in ogoro-oro village,
gunungkidul during covid 19 pandemic
……………………………………………………………………………………………………………………………….
4 Foreign language skill Speaking Reading Writing
Fluently Enough Good Enough Good Enough
English v v v

5 TOEFL/ TOEIC Test

v Yes, Year 2019 Administrator IONs Yogyakarta Score 453 No

V. SOCIAL ACTIVITY AND OTHERS

1 Organization/Institution Membership
Organization Name Location Position Period
Marching Band UGM Yogyakarta Player Brass 2016-2018
Kelompok Studi Kelautan Fak. Biologi Yogyakarta Staff 2016-2017
Teknologi Tepat Guna Yogyakarta Assistant Research 2018-2020

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PANDU ANUGERAH ANALITIKA HOLDING COMPANY
HeadQuater Building, Tamini Interchange
Jl. Raya Pondok Gede No. 5 Dukuh Kramatjati Jakarta - Indonesia
Application
Tel: +62 21 80878498 Form

2 Activity in your spare time (hobby): Cooking, Gardening, Movie, Jogging

………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
3 Newspaper/Magazine that you read: E-Newspaper/Magazine like Narasi, Detik.com, etc
………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
4 Favorite topic that you read: Culinar, Plants, Film, etc
………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………

VI. GENEALOGIST

1 You leave in:

a. ownhouse b. parent c. rent d. boardinghouse e. …………………….
2 You are : 7 from 8 Sisters/Brothers
3 Parents Name Age Last education Occupation
Father Syamsul Bahri 70 SD Farmer
Mother Yurniati 63 SD Housewife
Address Jl. Singa Harau, Kel. Balai Panjang, Kec. Payakumbuh Selatan

Zip Code 26226

Telephone: (+62) 82173000203
4 Brothers/sisters Name Age Education Occupation
1 Yusmaini 46 SMA Housewife
2 Juliadi 45 SMA Self employed
3 Sielviera 42 SMA Self employed
4 Oktrinaldi 40 SMA Farmer
5 Dedi Antoni 36 SMA Self employed
6 Laila Imelda 30 SMA Self employed
7 Algia Amina Fanesa 20 Bachelor Student
5 Husband/Wife
1
6 Children
1
2
3
4

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PANDU ANUGERAH ANALITIKA HOLDING COMPANY
HeadQuater Building, Tamini Interchange
Jl. Raya Pondok Gede No. 5 Dukuh Kramatjati Jakarta - Indonesia
Application
Tel: +62 21 80878498 Form

7 If there is an accident happent to you, what should we contact:

Address Jl. Singa Harau, Kel. Balai Panjang, Kec. Payakumbuh Selatan
………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
Teleph : (+62) 082173000203 Zip Code 26226

VII. OCCUPATION BACKGROUND

1 Now Before
Company details
Name
Address

Telephone
2 Your Top Position
Name
Title
3 Job Details
Position
Job Description
Periode
Your Staff
Basic Salary
Allowance

Facility

Resign reason

4 Achievement during your work period:

…………………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………………..
5 Mention your career day: I want to work where I can develop my skills and thus can enhance my career
……………………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………………..

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PANDU ANUGERAH ANALITIKA HOLDING COMPANY
HeadQuater Building, Tamini Interchange
Jl. Raya Pondok Gede No. 5 Dukuh Kramatjati Jakarta - Indonesia
Application
Tel: +62 21 80878498 Form
VIII. POINTS ABOUT APPLICATION
1 Have you ever applied in Pandu Holding Cmpany before?

Yes, Position that applied : ……………………………………………. No

2 What is your reason apply in Pandu Holding Company? Because this potision suitable with my background
……………………………………………………………………………………………………………………………..

3 Where do you know about this vacancy? Telegram

……………………………………………………………………………………………………………………………..
4 Work circumtances that you like and the reason:
a. Office b. Workshop c. Outdoor d. ………………………………….
Reason: I like work in office but also workshop and outdoor. Therefore I haven't the monotone work situation
……………………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………………..

5 a Your expected salary : 5.000.000

b Your expected allowance : 4.000.000
c Your expected facility : Insurance, Career Path, Performace Recognition, etc
: …………………………………………………………………….
6 Do you agree to:
a. Doing probation period during 3 months Yes No
b. Assigment in other city Yes No
c. Placed in other city Yes No
d. Work overtime Yes No

IX. OTHERS

1 Have you ever work/have a connection with customer or bidder of Pandu Holding?
Yes, Company Name:……………………………….. No
2 Have you ever work/have a connection with group/ afiliation of Pandu Holding?
Yes, Company Name: ……………………………….. No
3 Have you ever suffer critical illness?
Yes, Name of illness: ……………………………….. No
4 Have you get a critical accident?
Yes, Name of illness: ……………………………….. No

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PANDU ANUGERAH ANALITIKA HOLDING COMPANY
HeadQuater Building, Tamini Interchange
Jl. Raya Pondok Gede No. 5 Dukuh Kramatjati Jakarta - Indonesia
Application
Tel: +62 21 80878498 Form

5 Are you smoking?

No
6 Blood Type: O
7 Vehicle that you used : Motorcycle ……………………………………………………………………………
Property:Parent ………………………………………………………………………………………
Driving License that you have: SIM C
8 Employee that you know in Pandu Holding: ……………………………………………
Your relationship with him/her is …………………………………………………………………………………………….
9 Please write 2 (two) name who can give you reference:
Reference 1 Reference 2
Name / Position
Company
Address
Phone
Connection with you
Can we contact the person right now?

10 If you are accepted in Pandu Holding , when you ready to work?

Soon

This application form is fulfilled by me with honestly as things have panned out.
If we found something not right in future, I am ready to be claimed with appropriate law in Indonesia.

Jakarta, 19 April 2021

( Rana Puti Lembayu )

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