JOB APPLICATION FORM

Position Applied:

 PERSONAL DATA
Full Name Mutiara Wahyuni
Place/Date of Birth Jakarta, 10 Maret 1997
National ID Number 3328105003970001
NPWP Number -
Marital Status single
Email Address Mutiaraw94@gmail.com
Phone Number 088233688232
Permanent Home Address Current Home Address
(based on your National ID Number): (if different from Permanent Home Address):
Jl Randu No. 40 01/03 Kagok Slawi Tegal Kos Pak Diyarko Gg. Pete Raya 01/01
Sekaran Gunungpati Semarang

Phone Number: 088233688232 Phone Number: 088233688232

 FAMILY
Name Education Occupation
Father Wahyudi SMA Buruh
Mother Sugiarti SD Ibu Rumah Tangga
Spouse
Children 1
Children 2
Children 3
...

Please list 3 persons that we can contact, in case of emergency:

Relationshi Phone
Name Address
p Number
Family / non- Muhammad Nephew Jl. Randu 001/003 08538580477
family living Khirzam Baehaqi Kagok Slawi Tegal 4
together in one
house
Family / extended Sugiarti Mother Jl. Randu 001/003 08538580477
family living in Kagok Slawi Tegal 4
different address
Friends / relatives Ayu Friend Kos pak diyarko gg 08157522042
pete raya 01/01 5
sekaran gunungpati
semarang

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 EMPLOYMENT APPLICATION FORM

 EDUCATION
Formal Education
School/ Institution Start –
Faculty Major Location GPA
Name Finish Year
Diploma
I/II/III*
Bachelor Universitas Negeri Ekonomi Accountin Semarang 2015-2022 3,63
Semarang g
Education
Master
Doctoral
*mark that fit your education

Informal Education / Training / Course / Seminar

No Subject / Topic Duration Provider Certificate
1. Journalist goes to Campus 1 days HIMA PE UNNES No
2. Yes/No*
3. Yes/No*
4. Yes/No*
5. Yes/No*
*mark that fit you

 SKILLS
Language (foreign language)
Writing Speaking
No Language
Poor Fair Good Poor Fair Good
1. Bahasa Indonesia Good Good
2. Bahasa Inggris Fair Fair
3.

Job-related skill (computer program, programming language, assessment tools, etc).

Rating
No Skill Name Description & Application
Poor Fair Good
1. Spreadsheet Membuat laporan keuangan di excel Fair
2. Myob Aplikasi Akuntansi Fair
3.

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 EMPLOYMENT APPLICATION FORM

 JOB EXPERIENCES
(Start from the latest)
Join Leave
Company Name Position Salary
Date Date
Nyess Juice Karyawan Oktober September Sekitar
2019 2021 1.500.000

May HR contact
Supervisor’s
Supervisor’s Name Supervisor’s Email your
Phone Number
Supervisor?

Were you a Supervisor in this position? Yes/No

If yes, how many people did you supervise?

Summary of Job Description Reason For Leaving

Mengerjakan skripsi

Join Leave
Company Name Position Salary
Date Date
Mitra cellular Admin Maret April Sekitar
2017 2018 600.000

May HR contact
Supervisor’s
Supervisor’s Name Supervisor’s Email your
Phone Number
Supervisor?

Were you a Supervisor in this position? Yes/No

If yes, how many people did you supervise?

Summary of Job Description Reason For Leaving

Jadwal tubrukan dengan
kuliah

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 EMPLOYMENT APPLICATION FORM

Join Leave
Company Name Position Salary
Date Date

May HR contact
Supervisor’s
Supervisor’s Name Supervisor’s Email your
Phone Number
Supervisor?

Were you a Supervisor in this position? Yes/No

If yes, how many people did you supervise?

Summary of Job Description Reason For Leaving

 ACTIVITIES & CAREER INTEREST

Organization Activities
DD-MM-YY –
No Organization Name Position Place
DD-MM-YY
HIMA Pendidikan Ekonomi Member UNNES Maret 2016 –
1.
Maret 2017
Baksos Unnes Member UNNES Agustus 2017 –
2.
December 2017
3.
4.
5.

Please mention your hobbies!

Membaca, berenang dan mendengarkan musik
What would you do in your spare time?
Membaca dan mendengarkan musik

In which division and position are you interested in the future?

Keuangan dan Administrasi
Where do you know about Veda Praxis and where you know the job vacancy from?
Linkedin dan Jobstreet
Please explain, why you want to work in Veda Praxis?
Menambah pengalaman dan tertarik karena berada di lingkup keuangan
Are you available working long hours and on weekends/public holiday when request?
(please explain)
Saya sebisa mungkin mengerjakan tugas di jam kerja saya namun apabila ada keadaan yang
sangat mendesak maka saya bersedia bekerja di luar jam kerja dengan kompensasi yang
sesuai
If Yes, when will be the latest time you are willing to work? (Please select from below options)
Anytime After Midnight 23.00 21.00 19.00

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 EMPLOYMENT APPLICATION FORM

 REMUNERATION
Please mention the salary and benefit expectation.
Current Monthly Salary Desired Monthly Salary
0 Net/Gross Rp. 3.000.000 Net
Current Benefit
Benefit Amount
0 0
0 0
0 0

 OTHER INFORMATION
Have you applied to Veda Praxis before? If yes, please mention the time and position applied.
Tidak pernah
Do you have relatives and or friends who worked in Veda Praxis? If yes, please mention the
name(s) and relationship(s).
Tidak ada
Do you also apply to any other company? If yes, please mention the company and position
applied.
Ya, PT. POPSEA sebagai Site Manajer
Do you have any part-time jobs? If yes, please explain.
Sudah tidak
Have you ever had serious illness or undergone surgery or gotten into serious accident? If yes,
please explain.
Tidak ada
Do you have any serious illness that require specific condition for working? If yes, please
explain.
Tidak ada
In your opinion, what is your 5 strength?
1. Detail-oriented
2. Mudah berbaur dengan orang
3. Cekatan
4. Teliti
5. Jujur
In your opinion, what is your 5 weakness that you need to improve ?
1. Perfeksionis
2. Gampang gugup didepan banyak orang
3. Belum bisa mengelola waktu dengan baik
4. Terlalu fokus pada pekerjaan
5. Kurang Percaya diri
Please mention further information which may be helpful in considering your qualifications.
Saya harap pengalaman serta skill dan pemleajaran yang saya terima dari kampus bisa
menjadi pertimbangan untuk menerima saya.

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 EMPLOYMENT APPLICATION FORM

STATEMENT APPLICATION:
By completing and sending all application documents to Veda Praxis, I, the undersigned, certify
that:
 All information provided during the recruitment and selection process is correct.
 I truthfully declare that I have never been involved in type of legal case and currently not
undergoing any legal proceedings.
 I am an integrity, honesty, and have a good self-concept person in everyday life and in
social media (cyberspace), do not engage in and do not engage in self-concept activities
that endanger myself and will harm the company and co-workers .
 I have a clean self-image on social media, do not use social media for things that are
against morals, law, politics, SARA.
 I am willing to not bring the good name of the Company, management and colleagues in
conflicts that occur in the personal sphere, including but not limited to: family, friends and
communities.
 I understand that if after I have been accepted to work at Veda Praxis and found that
things are not in accordance with the terms above, I am willing to resign or be terminated
from the company without demanding for any consequences from the company, including
being willing to waive clauses related to Termination of Employment and severance pay
in PKWT and PKWTT.

I hereby certify that all the information given above is true and if under any circumstances
omission or misrepresentation is found, I understand that I shall be fully held responsible. By
sending this data, I acknowledge and agree that the data will be used in the recruitment and
staffing process, including being stored and processed in a third-party HRIS application.

Date : 29 Agustus 2023

Applicant Signature

( Mutiara Wahyuni )

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