CONFIDENTIAL

PT. HIDRONAV TEHNIKATAMA

Jl. Pondok Bambu Batas No. 10
Pondok Bambu, Duren Sawit
Jakarta 13430, Indonesia

EMPLOYMENT APPLICATION

Affix
passport
size
photograph
here

FOR THE POST OF:

PERSONAL / FAMILY PARTICULARS

FULL NAME (as in “KTP/ID)” Underline Surname Mr / Mrs / Miss / Madam

Alias / Other Name (if any) KTP/ ID No:

Permanent Address Telephone No.

Home:
H/P:
Postal Code ( )

Date of Birth Country of Birth Citizenship Marital Status

Sex Religion Language Others

Male / Female 1.
2.

FOR FOREIGNERS
Passport No. / Identification No. Work Permit No. / Employment Pass No. Date Issued Expiry Date

Give particulars of your family members and indicate your relationship with them eg. spouse, father, mother,
son, daughter, brother, sister. (use separate sheet if insufficient space)
Name Age Relationship Occupation Employer

EMERGENCY Contact Person Relationship Contact Number

 CONFIDENTIAL
TRAINING / EDUCATION
School / Institution From To Course/ Major Highest Standard
Name / Country DD/MM/YY DD/MM/YY

Scholarship / Merit Awards From To Course Content of Scholarship /

Awards

Course Currently Attending/ From To Course Indicate if course

Institution Name DD/MM/YY DD/MM/YY / Major is company sponsored

GENERAL INFORMATION
PROFESSIONAL MEMBERSHIP (Attach supporting document)
Name of Institute Country Membership Type Member since

EXTRA-CURRICULAR ACTIVITIES
At School At University / College At Present
Sports / Games

Membership of Club,

Society, Association, etc.

KNOWLEDGE OF COMPUTER / GPS RELATED HARDWARE / SOFTWARE

1. 2. 3. 4.

KNOWLEDGE OF LANGUAGES
Written Spoken

HOBBIES / INTERESTS
1. 2. 3. 4.
 CONFIDENTIAL
Begin with most recent employer, attached relevant document such as salary slip, letter
of commendation, etc.
EMPLOYMENT HISTORY
EMPLOYER 1
From To Name of Employer Job Title Supervisor’s
DD/MM/YY DD/MM/YY Job Title

Basic Salary Bonus Allowance Others Reason for Leaving

Starting Ending

Duties & Responsibilities Major Achievements

EMPLOYER 2
From To Name of Employer Job Title Supervisor’s
DD/MM/YY DD/MM/YY Job Title

Basic Salary Total Annual Bonus Allowance Others Reason for Leaving
Cash
Starting Ending (please state no. of months)

Duties & Responsibilities Major Achievements

OTHER EMPLOYERS (if any)

From To Name of Employer Job Title Reason for
DD/MM/YY DD/MM/YY Leaving
 CONFIDENTIAL
1 Describe a difficult situation you encountered in previous job/task and how did you resolve it?
Situation/Task
Choose the most difficult experience;
when did it happen; what task or
situation were you working on when
the difficulty arose; elaborate the
problem and how difficult it was

Action
What was your approach towards that
problem; what specific actions did you
do; how did you do it; what was
happen after you did it, was there
another problem arose; if yes what did
you do next

Result
What was the result, please describe

2 How do you handle a challenge? Give an example when you did face it in the past.
Situation/Task
Choose the most challenging
experience; when did it happen; what
task or situation did you face;
elaborate the situation and how
challenging it was

Action
What was your approach to the
challenge at that time; what specific
actions did you take; how did you do
that; what happened after you did, did
any other problems arise; if yes what
did you do next

Result
What was the result, please describe

3 Describe a time when you had to work with a difficult coworker. How did you handle the
interactions with that person?
Situation/Task
Choose the most difficult moment;
when did it happen; what task or
situation did you face; elaborate the
situation and how difficult it was

Action
what specific actions did you take; how
did you do that; what happened after
you did, did any other problems arise;
if yes what did you do next

Result
What was the result, please describe
 CONFIDENTIAL
OTHER INFORMATION

Please answer the following questions:

1. Do you suffer from any physical impairment or disease including mental illness, deafness
handicap, etc.? Yes / No *

If yes, please specify:

2. Have you applied to PT. HIDRONAV TEHNIKATAMA before? Yes / No *

If Yes, when? Position

3. Do you have any relative / friends presently employed by PT. HIDRONAV TEHNIKATAMA? Yes / No *

If yes, please specify:

4. How were you referred to the position applied for at PT. HIDRONAV TEHNIKATAMA?

Advertisement ( ) Friends / Relatives ( ) Employment Agency ( ) Other sources:

5. Do you have any obligation to your present company in terms of bond, study loans, etc? Yes / No *
If yes, please give details:

Name Relationship Department Job Title

Minimum Expected Salary Notice Period Required Earliest Start Date

REFEREES
Name Address Telephone Occupation Years Known

DECLARATION

I understand that any false statement made by me on this application or any supplement thereto will be sufficient
ground for disqualification or dismissal if appointed. The willful suppression of any material fact will be similarly
penalised.

I authorised PT HIDRONAV TEHNIKATAMA to make reference to all my past employers on my job performance.
However, reference to my current employer may only be made with my prior permission so long as I am still in
their employment.