Curriculum Vitae – Application Form

I. PERSONAL DATA
1. No. Kartu Tanda Penduduk (KTP) – supply
colored scan copy
2. Full name
3. Nickname
4. Birthplace, Date of Birth
5. Home Address
6. Phone/Mobile Phone
7. Email
8. Social Media LinkedIn :
Instagram :
Facebook :
Twitter :
Others :
9. Interests/Hobbies
10. Nationality
11. Religion
12. Ethnic
13. Church Member/Denomination

II. FOR EXPATRIATE TEACHERS:

14. Passport Number and Expiration Date
Please make sure it has min 18 months and
supply a colored scan copy of the passport
cover, identity page, and the valid visa page
15. Kindly specify the Visa that you use at the
moment
Please supply a colored scan copy of the stay
and work permit
16. Address in Indonesia

III. FAMILY DETAILS

1. Marital Status
2. Name of Spouse
3. Nationality
4. Occupation
5. Spouse Birthplace, Date of Birth
6. Religion
7. Details of Children 1.
DOB:
Gender:

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 2.
DOB:
Gender:

IV. PREVIOUS WORK EXPERIENCE – please add as many lines as you need
Name of Company –
Position Period Salary
City/Country

Responsibilities:

Reason for Resignation:

Number of Employees:

Direct Supervisor / Director :

Name of Company –
Position Period Salary
City/Country

Responsibilities:

Reason for Resignation:

Number of Employees:

Direct Supervisor / Director :

Name of Company –
Position Period Salary
City/Country

Responsibilities:

Reason for Resignation:

Number of Employees:

Direct Supervisor / Director :

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Please draw a simple chart showing your position in the organization

V. OTHER WORK RELATED EXPERIENCE

No. Name Responsibility Additional Information

VI. EDUCATIONAL BACKGROUND

A. Formal Education (please supply a colored scan copy of the certificate – 300 dpi)
Level School /
Course Graduating Year
University

B. Non Formal Education (please supply a colored scan copy of the certificate – 300 dpi)

Name of Institution Year

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 C. Language Skills

Languages Spoken Proficiency Level

D. Others

Organizations, Clubs, Affiliations Position Period

VII. Professional References

Full Name
Position Held
Phone/Mobile Phone
Email
Relationship

Full Name
Position Held
Phone/Mobile Phone
Email
Relationship

Additional Information
Position Applied
Salary Expected
Facilities Expected
When are you available to start work?
Could you provide the original documents Yes / No
to be checked?
Describe the kind of job that is in line with
your career plan
Describe the kind of job that you don’t like

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 1. How do you know about this vacant position?

2. Have you ever applied to BPK PENABUR Jakarta before?

If yes, please specify:

Year Position applied Process stages
( ) Interview Process
( ) Demo Teaching
( ) Material Test
( ) Psychological Test
( ) Health Test
3. Which other companies are you applying to and what is the position applied?
4. Do you have any objections if we want to contact your previous employer for reference
checking?

Full Name
Position Held
Phone/Mobile Phone
Email

Emergency Contact - Name:

- Relationship:
- Address:
- Phone number:
- Email:

I hereby certify that the information given above is true and if under any circumstances any
misrepresentation or omission of information is found, I understand and that I shall fully be held
responsible.

Full Name:
Date:
Signature:

(____________________________)
Applicant

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