JOB APPLICATION FORM

PERSONAL INFORMATION
Name : NANDA RIZKI

Place / Date of Birth : Tangerang / 1998-07-26

ID Card Number : 3603152607980004

Address on ID Card : Kp.bonisari rt/rw 01/02 bonisari pakuhaji tangerang banten 15570
 
BANTEN
, Kabupaten tangerang

Current Address : Kp.bonisari rt/rw 01/02 bonisari pakuhaji tangerang banten 15570
 
BANTEN
, Kabupaten tangerang

Mobile Phone Number : 085891224233 Home Phone Number :

Office Phone Number : Email Address : nandarizki@nndasite.com
Gender : Male Blood Type :A
Religion : Islam NPWP Number : 830287637418000
BPJS Kesehatan Number :- BPJS Ketenagakerjaan Number : -
Status : Single Nationality : Indonesia
Height : 168 cm Weight : 51 Kg
Sport / Hobbies : Balap lari

In case of emergency : Nursiah Phone Number : 085717964502

who should we contact? Relationship : Orang tua

FAMILY
Relationship Name Age Education Occupation Company/Institution
           

FORMAL EDUCATION
Degree Name & Location of Institution Major GPA Period Graduated
           

NON FORMAL EDUCATION/TRAINING/COURSE/SEMINAR (Start with the most recent.)

Type of
Date / Period Certified
education/training/course/seminar
     

ACADEMIC AND PROFESSIONAL ACTIVITIES AND ACHIEVEMENTS

Academic and professional activities, achievements, awards, publications, or technical-professional communities. Indicate type
Date/Period
or name

Form No: F-HR2-002 Rev. 2

EMPLOYMENT HISTORY (Start with the most recent.)

Name & Address of

Company/Institution

Period (Month/Year) Entry: Exit:

Entry Position:
Position
Last Position:

Major Roles & Duties

Salary (Net) Entry: Last:

Other Benefits

Reason of Leaving

REFERENCES(list of referees who know your academic or professional performance, not family member)
Name Address Phone Number Relation

SKILLS
Language (not your native language):
Reading Writing Speaking
Language
Poor Fair Good Poor Fair Good Poor Fair Good

Computer Skills

Other Skills

PREFERENCE OF PROFESSION
Accounting Finance Marketing
Sales Supply Chain MIS
Human Resources Production Engineering
R&D/QA Other :

PREFERENCE OF INDUSTRY
Manufacturing Financials Property
Natural Resources Retail & Trading Other :

SALARY EXPECTATION
IDR 0
ADDITIONAL INFORMATION
Have you ever applied to PT Gajah Tunggal Tbk before?

If yes, when?
Company: -
Do you have any special medical condition?

If yes, please explain:

-
Other companies outside PT Gajah Tunggal Tbk you are applying to:
-

List of friends or relatives now employed by PT Gajah Tunggal Tbk:

Name Position Relationship

ESSAY

Please think about yourself and answer these questions:

1. What is your goals in life?

2. Please mention your strength and weaknesses!

3. What do people think or say about you?

4. Other information that you would like to share which may be helpful in considering your qualifications and interests.

1. -
2. -
3. -
4. -

PLEASE READ THIS STATEMENT CAREFULLY

I hereby confirm that the information given by me on this Job Application Form is accurate. I understand that any falsification will be considered as a
sufficient cause for dismissal. I authorize PT Gajah Tunggal Tbk to do a thorough investigation in regards of this application concerning my personal
information, education background, employment history and any breach of rules.

________________________ _____/_____/________
Name & Signature Date

Thank you for taking time to complete this application