ESB APPLICANT FORM

Position Applied :

PERSONAL DATA
Gender : Mr / Mrs / Ms *Strikethrough unnecessary
Full Name :
Religion :
Place & Birthdate :
Contact Number :
Email :
KTP Number :
Address :
Marital Status : Single / Married / Divorced / Widow/er *Strikethrough unnecessary

EDUCATION
Formal Education *Begin from your last education
No Institution Name Major Place Period
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Certification *Begin from your last certification
No Institution Name Certification Name Place Period
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3

WORKING EXPERIENCE *Begin from your last/current experience

No Company Name Position Period Reason for Leaving
1
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3

WORKING REFFERENCE *Fill with your Ex-Direct Leader & Ex-HR

No Name Position Relationship Contact Number
1
2

EMERGENCY CONTACT *Fill with your nearest family

No Name Position Relationship Contact Number
1
2

REMUNERATION
Current/Last Salary :
Current/Last Benefits :
Expected Salary :
Expected Benefits :

I hereby declare that all contents that I have written on this form are true and can be accounted for.
If it is proven that there is falsification of data, it will be processed according to related law.