CONFIDENTIAL

ADARO JOB APPLICATION

Position Applied : Date of Interview :

I. PERSONAL DATA

Full Name (according to ID Card) :

Nick Name : Gender :
Religion : Blood Type :
Place/Date of Birth : /
Marital Status :
ID No. :
Nationality :
Mobile Phone No. :
Email :
Address According to ID Card (required)
City: State/Province: Country: Zipcode:
Home Phone No.:
Housing Status**
Personal Relatives
Parents Rental Others:
Current Address (required)
City: State/Province: Country: Zipcode:
Home Phone No.:
Housing Status **
Personal Relatives
Parents Rental Others:
Emergency Family Contact Info (required)
Name : Home Phone No. :
Relationship : Mobile Phone No. :
Address :

SOCIAL MEDIA UNIFORM

Facebook : Clothes size :
Instagram : Pants size :
Twitter : Shoes size :
Linkedin : Height/Weight : cm / kg
Personal Blog :
Only filled in for positions that require uniforms.

2. FAMILY DATA
Please write your family data, including yourself. Please give (late) behind the last name if the person has been passed.

I am the of children
Family Place, Latest Education/
Name M/F Latest Occupation
Relationship Date of Birth Major
Father
Mother
Sibling 1
Sibling 2
Sibling 3
Sibling 4
Sibling 5

** Cross your choice

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If you have married, you are required to fill this table. Please give (late) behind the last name if the person has been passed.

Family Place, Latest Education/

Name M/F Latest Occupation
Relationship Date of Birth Major
Husband/Wife
Child 1
Child 2
Child 3

3. EDUCATIONAL BACKGROUND
A. Formal Education. Please sort from the most recent level of education.

Level of Name of School / Year

City Major/ Faculty GPA/ Score
Education University (Start - End)

B. Informal Education. (i.e: certification, seminar, training, workshop, course, etc.)

Certified
Name of Event Place Name of Institution Duration Year
(Y/N)

C. Competencies. (i.e: language, computer, etc.)

Competency Competency

4. ORGANIZATIONAL EXPERIENCES, ACHIEVEMENT, & SCHOLARSHIPS

A. Please write max. 3 organizational or organizing commitee experiences, that you think that you had contributed to the most.

Month, Year
Organizational Name Organizational Level Type of Organization Position
(Start - End)

B. Please write max. 2 of your most valuable achievements/honor/distinction from competitions, that had occured in the last 6 years.

Achievement Achievement Level Title Award Giver Year

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C. Please write max. 2 of scholarship that you received in the last 6 years. Please only include scholarships obtained based on merit.

Name of Scholarship Scholarship Level Scholarship Giver Type of Scholarship Year

5. WORKING EXPERIENCES
Please write your working experience start from current position.

Company Name : Industry :

Position : Month, Year :
Job Description : Reason for leaving :

Company Name : Industry :

Position : Month, Year :
Job Description : Reason for leaving :

Company Name : Industry :

Position : Month, Year :
Job Description : Reason for leaving :

Please draw your position in your current working structure organization, then upload the picture to the box below.

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ADARO JOB APPLICATION

6. REFERENCES AND PERSONAL QUESTONS

How do you get information about this vacancy?

Career Website :
Campus/Career Fair :
Recruitment Agency :
Referral :
Others :

Mention min. 2 names of your previous supervisor who can provide recommendations about you.

Full Name Position Company Name Telephone/Handphone Number

Please write 3 of your strengths

Please write 3 of your weakness

Answers
Questions
Y/N Explanation (if the answer "Y")

Company Name :
Have you worked at Adaro Group before? Last Position :
Date of Join : to
What's the reason you left Adaro Group?

Have you been processed at Adaro Company Name :

Group recruitment before?
Applied Position :
Year :

Full Name :
Do you have any family member or any Company Name :
acquaintance who works at Adaro Group?
Position :
Relationship :
Mobile Phone No. :

Are you in a recruitment process at Company Name :

other company? Applied Position :
Please write recruitment stages that you've followed.

** Cross your choice

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ADARO JOB APPLICATION

Answers
Questions
Y/N Explanation (if the answer "Y")

Company Name :
Are you on an official bond?
Year : to

Are you willing to be assigned at another

city?

I hereby declare that the information that I had provided is true and correct. I understand that Adaro Group have the right to reject my
application or cut off work relation if the information provided was found to be false.

............................, 09 Mar 2023

(..........................................................)

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