APPLICATION FOR EMPLOYMENT

Position Applied for: SALES LAND TRANSPORT Date: 14/05/2024

Full Time Contract / Part Time (_____ months)

Date Available / Current Notice Period ?

(photo)
The information that you give in this confidential document will only be used in relation to your employment through PT
Schenker Logistics Indonesia. and its associated companies and will NOT be disclosed to other parties without your
written permission.

Please write in block letters using a pen (no pencil allowed). When necessary continue your paper on a separate sheet
of paper. It is mandatory to complete all information.

1. General
How did you find out about the position? Agency Job Portal Other ……………...

Employee Refferal Name of referrer:

Have you made previous applications to, or worked for, Schenker before? Yes No
Do you have a family member or relative that works at PT Schenker Logistics Indonesia? Yes No
NB: PT Schenker Logistics Indonesia is proactively managing potential conflicts of interest
Is your existing employer a client of PT Schenker Logistics Indonesia? Yes No
Are you willing to be considered for other positions at Schenker? Yes No
Do you have an existing employment contract that bonds you to them? Yes No
(i.e. Do you have to pay them is you join us?)
2. Personal Information
Full Name: ERLITA EKAWATI
SURABAYA, 23-03- Male Female
Place & Date of Birth: Gender: Nationality: WNI
1993
Marital Status: MARRIED Children: 2
Permanent Address: MEDOKAN SEMAMPIR BLOK H/34 SURABAYA Postcode:
Telephone Number: Home Mobile 085643211989/082228547717
Email Address: erlitaekawati03@gmail.com
LinkedIn: - Instagram: rlitak_
Twitter: - Facebook: -
Religion: ISLAM
E-KTP Number: 3578096302930001
NPWP Number: 81.615.899.2-606.000
BPJS Kesehatan
0000786046217 Name of Medical Facility:
Number:
3. Family Member
Family Full Name Age Occupation
Spouse FATNY CHOLID 35 SWASTA
1 child
st
DARRA DINANTI 11
2nd child AKMAL PUTRA 5
3 child
rd

4. Relative Member
Family Full Name Age Occupation
Father DJALIL 60 SWASTA
Mother SUKAISI 55 -

O
PT Schenker Logistics Indonesia Page 1 of 5 FRM-02/WI/HR-04/Rev.02/
Human Resource Department – Recruitment Effective Date 7 Feb 2023
 APPLICATION FOR EMPLOYMENT
1st sister / Brother
2nd
3rd
5. Emergency Call
Contact Person Relationship Address Mobile No
GRAHA
KUNCARA
SADDAM SEPUPU
EKSEKUTIF +62 856 48045912
AG/10

6. Education Profile
Qualification Institution / Country Year commenced Year Completed Full Time / Part-Time
SENIOR HIGH
TRIMURTI SURABAYA 2008 2011
SCHOOL
UNIVERSITY AIRLANGGA SURABAYA 2011 2014

7. Training - (Please give details of any training undertaken which is relevant to the position for which you are applying)
Date (mm/yy) Name of Course* Institution

* Please attach partial results if available

8. Computer Literacy & Other Skills - please indicate the software you are competent in
MS OFFICE
ORACLE
WINDOWS
9. Employment History – (Please provide full details of all employment over the last 5 years starting with your most recent employer – if you are able to
attach a CV which provides all the detail below please do so.)
From: Jan 2021 To: Feb 2024 Position: DELIVERY SUPERVISOR
Company: PT. GOTO GOJEK Monthly Base Salary:
TOKOPEDIA 8.000.0000
Name Supervisor: Erky Can we contact your current employer at this
Title: SE time for a reference? Yes ( v) No ( )
Febriansyah

Brief Outline of Responsibilities: Overseeing the operation and escalating any issues to Manager/Analyst te

Reasons for Leaving:

Bussiness is failing
From: Feb 2020 To: Dec 2020 Position: SALES PROJECT SUPERVISOR
Company: PT.
Monthly Base Salary:
MULTIFORTUNA SINAR
8.000.0000
DELTA
Can we contact your current employer at this
Name Supervisor: Wahyu Title: SE time for a reference? Yes ( v ) No ( )

Brief Outline of Responsibilities: Prepare and arrange Pipeline Project sales based on the Project Information obtained

O
PT Schenker Logistics Indonesia Page 2 of 5 FRM-02/WI/HR-04/Rev.02/
Human Resource Department – Recruitment Effective Date 7 Feb 2023
 APPLICATION FOR EMPLOYMENT
Went out of business
Reasons for Leaving:

From: To: Position:

Company: Monthly Base Salary:
Can we contact your current employer at this
Name Supervisor: Title: time for a reference? Yes ( ) No ( )

Brief Outline of Responsibilities:

Reasons for Leaving:

From: To: Position:

Company: Monthly Base Salary:
Can we contact your current employer at this
Name Supervisor: Title: time for a reference? Yes ( ) No ( )

Brief Outline of Responsibilities:

Reasons for Leaving:

From: To: Position:

Company: Monthly Base Salary:
Can we contact your current employer at this
Name Supervisor: Title: time for a reference? Yes ( ) No ( )

Brief Outline of Responsibilities:

Reasons for Leaving:

10. Language – please circle Good (G), Fair (F), or Poor (P)
Language Spoken Written Listening Reading
English G G G G
Deutsch G/F/P G/F/P G/F/P G/F/P
Other: G/F/P G/F/P G/F/P G/F/P
11. Professional Club Organizations
From To
Association/Club/Society/Company Position Held
(mm/yy) (mm/yy)

12. Hobbies / Interest

Travelling, Hiking

13. Personal Reference (Please provide details of 2 referees known to you for at least 5 years who are not former employers or relatives)
Name: Erky Febriansyah Name: Wahyu

O
PT Schenker Logistics Indonesia Page 3 of 5 FRM-02/WI/HR-04/Rev.02/
Human Resource Department – Recruitment Effective Date 7 Feb 2023
 APPLICATION FOR EMPLOYMENT
Address: - Address:
Occupation: Area Manager Occupation: District Head
Company: PT. GOTO GOJEK PT. MULTIFORTUNA SINAR
Company:
TOKOPEDIA DELTA
Telephone No: +62 888-0492-
Telephone No: +62 819-3858-3012
0077
14. Remuneration
Last Drawn/Current Salary (Gross): Rp 8.000.000 Per month Rp Per annum
Expected Salary (Gross): Rp 8.000.000 Per month Rp Per annum
Last Increment: Rp With effect from (please descript)
May we have the original copy of your Yes No
pay slip?
15. Additional Information
Housing: Own Family Rental

Vehicle: Own Family Rental

Type of Vehicle: Motor Cylce Car

Do you hold a current drivers license? Yes No Type:

16. Declaration
I have / Have not been suffering from any physical / contagious / hereditary / disabilities illness. If you have, please elaborate :
(riwayat penyakit yang pernah diderita, yaitu parah / ringan / fisik / menular / keturunan / ketidakmampuan fisik, etc)
NOT HAVE

My family / relatives member has / has not been suffering from any physical / contagious / hereditary / disabilities illness. If she /
he have, please elaborate: NOT HAVE

I have / have not been convicted for a criminal offence in a court of law. If you have, please elaborate: NOT HAVE

I have / have not been put in a situation of financial embarrassment. If you have, please elaborate: NOT HAVE

I declare that the information furnished in this application is true and correct to the best of my knowledge and belief, and that I
have not willfully suppressed any fact(s). If any information given herein is subsequently found to be incorrect, incomplete or
false, I render myself liable for dismissal. Any offer of employment, verbally or otherwise, will also be nullified.

I also authorize the company to submit the said information to any person, firm, corporation, body, bureau, Police or Government
authority for the purpose of any investigations and verification which the company deems it necessary to make with reference to
my employment, conduct or other details relevant to this application.

I shall not hold the company responsible for any liability, demand, claim, suit, proceeding, cost and expense of any nature arising
from the release of such information as foresaid.

I acknowledge and agree that Schenker Human Resources Department will do reference check on my existing companies if I
has joined Schenker.

Signature: Date: ______14/05/2024____________

Print Name: ERLITA EKAWATI

HR Use Only:

O
PT Schenker Logistics Indonesia Page 4 of 5 FRM-02/WI/HR-04/Rev.02/
Human Resource Department – Recruitment Effective Date 7 Feb 2023
 APPLICATION FOR EMPLOYMENT
Request to Hire No:

Signature: Date: __________________

Print Name:

O
PT Schenker Logistics Indonesia Page 5 of 5 FRM-02/WI/HR-04/Rev.02/
Human Resource Department – Recruitment Effective Date 7 Feb 2023