PT TUAH ENERGY NUSANTARA

JOB APPLICATION FORM

Position Applied For: ________________________________________________

PERSONAL INFORMATION

Name (as in passport): ____________________________________________

I am a (tick one):  Indonesian Citizen (Passport No.: ____________________)

 Permanent Resident (PR No.: ________________________)

 Others _____________________

Address: ___________________________________________________________

_______________________________________ Postal Code: ________________

Contact No.: __________________ Email address: _________________________

ACADEMIC QUALIFICATIONS
Date Schools/Institutions Qualifications Obtained (‘O’/’A’ Levels,
From To Attended Diploma, Degree)

OTHER QUALIFICATIONS / PROFESSIONAL BODIES

Registration
Year Qualifications / Professional Bodies
No.

MEDICAL HISTORY (if any)

No. Descriptions (Allergies/Disease) Medical Information Details

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 PT TUAH ENERGY NUSANTARA
JOB APPLICATION FORM
__________________________________________________________________________

EMPLOYMENT HISTORY
Date Firm/ Institution Oil &
Reason(s) for
(in chronological Position Held Gas
From To Leaving
order) Exp.

DETAILS OF CURRENT EMPLOYMENT

Present Employer :
Designation :
Key Responsibilities :
Notice required (to end present employment: (weeks)
Reason for leaving :

DECLARATION
Are you related to or have a close personal relationship with any employee in PT Tuah
Energy Nusantara?

YES NO

If YES, please give further details :

REFEREES

1. Name: ____________________ Designation: _______________________

Organisation Name: ____________________________________________
Contact No.: _________________ Email Address: ____________________

2. Name: ____________________ Designation: _______________________

Organisation Name: ____________________________________________
Contact No.: _________________ Email Address: ____________________

I declare that to the best of my knowledge the information given is true and correct. I understand
that inaccurate, misleading or untrue statements or knowingly withheld information may result in
termination of employment with this organisation.

I understand that this application does not constitute an offer of employment. I understand that,
in some cases, police and credit checks will be required and I will be notified if this applies to this
application.

Signature: ______________________ Date: __________________________

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 PT TUAH ENERGY NUSANTARA

NAME :

POSITION APPLIED FOR :

CURRENT SALARY :

EXPECTED SALARY :