JOB APPLICATION FORM

I. APPLICANT PERSONAL DATA

POSITION APPLIED:

COMPLETE NAME / NICK NAME:

3x4
ADDRESS (PERMANENT):

ADDRESS (TEMPORARY):

 Male Height: Weight: Religion: Nationality:

 Female ………… cm ………… kg
BIRTH PLACE: Date of Birth:
MARITAL STATUS: No. ID Card / Passport:
 Single  Widow / Widower Driving License: No. Driving License:
(A/B/C)
 Married  Divorce
No. of Chidren: Telephone no: Email address:
Handphone no:
SOCIAL MEDIA ACCOUNT :
LinkedIn : Twitter :
Instagram : Facebook :
Others :

II. EDUCATION (PLEASE WRITE DOWN ALL)

A. Formal Education
Education Level School Name Majo PERIOD GPA DEGREE
r
1. Elementary School ….. to …..

2. Junior High School ….. to …..

3. Senior High School ….. to …..
4. Undergraduate ….. to …..
5. Post Graduate ….. to …..
6. Others
B. Informal Education (Seminar/Training)
Informal Education Name Period
1.
PT Softex Indonesia

Head Office : The Prominence Tower, 5th Floor, Jl. Jalur Sutera Barat No.15, Alam Sutera, Tangerang, Banten 15143, Indonesia. T (6221) 3005 5108
Factory : Kawasan GT Tech Park Kav. 6-7, Komplek Industri Bintang Puspita Dwikarya, Wanasari, Karawang, Jawa Barat 41361, Indonesia. T (6221) 8060 4282
Komplek Industri dan Pergudangan Safe n Lock, B-2, Jl. Lingkar Timur, Rangkah Kidul, Sidoarjo, Jawa Timur 61234, Indonesia. T (6231) 5820 4767
No. Dokumen : FR – HR – 005
Revisi : 03
 2.
3.
C. Organization Activities
Organization Name Position Period
1.
2.
3.
4.
D. English Proficiency
English Proficiency Name Score Period Issued By
1. TOEFL
2. IELTS
3. Others
HOBBIES: LANGUAGE:
1. 1.
2. 2.
3. 3.

III. FAMILY (PLEASE INCLUDE YOURSELF)

Birth of CURRENT JOB

SEX LAST
RELATION NAME Date
(M/F) EDUCATION
(dd/mm/yy) Position Company
Father
Mother
Father in law
Mother in law
Brother/Sister 1
Brother/Sister 2
Brother/Sister 3
Brother/Sister 4
Wife/Husband
Child 1
Child 2
Child 3
Child 4
Others

IV. EMPLOYMENT HISTORY

A. Last /Current Employment:

Joined date: Company’s name:

Resigned date: Core business:
Start designation: Tel. no:
PT Softex Indonesia

Head Office : The Prominence Tower, 5th Floor, Jl. Jalur Sutera Barat No.15, Alam Sutera, Tangerang, Banten 15143, Indonesia. T (6221) 3005 5108
Factory : Kawasan GT Tech Park Kav. 6-7, Komplek Industri Bintang Puspita Dwikarya, Wanasari, Karawang, Jawa Barat 41361, Indonesia. T (6221) 8060 4282
Komplek Industri dan Pergudangan Safe n Lock, B-2, Jl. Lingkar Timur, Rangkah Kidul, Sidoarjo, Jawa Timur 61234, Indonesia. T (6231) 5820 4767
No. Dokumen : FR – HR – 005
Revisi : 03
 Last designation: Address:
Supervisor’s name: Director’s name:
Reason for leaving: Latest salary:

Facility(s)/Benefit(s) (details): Others:

B. Employment:

Joined date: Company’s name:

Resigned date: Core business:
Start designation: Tel. no:
Last designation: Address:
Supervisor’s name: Director’s name:
Reason for leaving: Latest salary:

Facility(s)/Benefit(s) (details): Others:

C. Employment:

Joined date: Company’s name:

Resigned date: Core business:
Start designation: Tel. no:
Last designation: Address:
Supervisor’s name: Director’s name:
Reason for leaving: Latest salary:

Facility(s)/Benefit(s) (details): Others:

How did you know PT. Softex Indonesia?

References:
Name Phone No. Relation Occupation & Company

PT Softex Indonesia

Head Office : The Prominence Tower, 5th Floor, Jl. Jalur Sutera Barat No.15, Alam Sutera, Tangerang, Banten 15143, Indonesia. T (6221) 3005 5108
Factory : Kawasan GT Tech Park Kav. 6-7, Komplek Industri Bintang Puspita Dwikarya, Wanasari, Karawang, Jawa Barat 41361, Indonesia. T (6221) 8060 4282
Komplek Industri dan Pergudangan Safe n Lock, B-2, Jl. Lingkar Timur, Rangkah Kidul, Sidoarjo, Jawa Timur 61234, Indonesia. T (6231) 5820 4767
No. Dokumen : FR – HR – 005
Revisi : 03
 Emergency Contact:
Name Phone No. Relation Occupation & Company

Please state your expected salary: ……………………….. to ………………………..

Please explain your job description and responsibility in current position

V. QUESTIONS

QUESTIONS YES NO REMARKS

1. Have you ever been sick for more than 7
consecutive days in the last 2 years? If yes,
please state your disease!
2. Have you ever been involved in criminal
case or politics, which causes you to be
detained by the enforced or be punished? If
yes, please explain!
3. Do you have a private vehicle? If yes, please
state!
4. Do you have a family/acquaintance who
works in PT. Softex Indonesia that willing to
take responsibilities of your
actions/statements? If yes, please write
down his/her name and your relationship
with him/her!
5. Are you willing/capable to work in PT.
Softex Indonesia with the conditions below:
a. Undergo 3 months’ probation period
b. Obey all rules that have been made and
will be made by the
company/supervisor
c. Will not demand:
i. Transport fee from and to the
office
ii. Housing from the company
PT Softex Indonesia

Head Office : The Prominence Tower, 5th Floor, Jl. Jalur Sutera Barat No.15, Alam Sutera, Tangerang, Banten 15143, Indonesia. T (6221) 3005 5108
Factory : Kawasan GT Tech Park Kav. 6-7, Komplek Industri Bintang Puspita Dwikarya, Wanasari, Karawang, Jawa Barat 41361, Indonesia. T (6221) 8060 4282
Komplek Industri dan Pergudangan Safe n Lock, B-2, Jl. Lingkar Timur, Rangkah Kidul, Sidoarjo, Jawa Timur 61234, Indonesia. T (6231) 5820 4767
No. Dokumen : FR – HR – 005
Revisi : 03
 d. Willing to be placed anywhere/any
positions according to the company’s
needs/decision
6. Please describe yourself with your own words, try to be as objective as possible without
explaining your background (education, experience, etc.). For example, try to explain by
answering these questions: What is the most important thing in your life? What are your
ambitions/goals? What motivates you? What is the foundation for your moral and ethics?
What other people’s opinions about you?

I hereby state that the above information is correct and true, and with this I state that if one day the
data/answer I have given are wrong, I will get my punishment according to the company’s
regulations. And I am willing to be fired/dismissed without demanding anything from the company,
if I violate the company’s regulations and/or the consequences of my actions are not reasonable and
endanger the company according to the company during the probation or after the probation
period.

……………………………, ………/………/………

______________________________

(NAME)

PT Softex Indonesia

Head Office : The Prominence Tower, 5th Floor, Jl. Jalur Sutera Barat No.15, Alam Sutera, Tangerang, Banten 15143, Indonesia. T (6221) 3005 5108
Factory : Kawasan GT Tech Park Kav. 6-7, Komplek Industri Bintang Puspita Dwikarya, Wanasari, Karawang, Jawa Barat 41361, Indonesia. T (6221) 8060 4282
Komplek Industri dan Pergudangan Safe n Lock, B-2, Jl. Lingkar Timur, Rangkah Kidul, Sidoarjo, Jawa Timur 61234, Indonesia. T (6231) 5820 4767
No. Dokumen : FR – HR – 005
Revisi : 03