HR-02

APPLICATION FORM
Application No. : __________ Photo

3 X 4

Please fill with capital letter.

A. PERSONAL IDENTITY

Full Name *) : FATCHAN RUZIQ AL FADILLAH

Place & Date of Birth : MAGETAN, 16 AGUSTUS 2005 Religion : ISLAM
Identity No. (KTP/SIM) : 3520121608050001 Nationality : INDONESIA
Email : fadillahfatchan@gmail.com
Address (Jakarta) Address (outside of Jakarta)
DS. BLARAN RT 013 RW 003 KEC. BARAT
KAB. MAGETAN

Telephone/Mobile Phone : Telephone/Mobile Phone : 081259015967

*) According to last certificate

B. EDUCATION

1. Formal Education
Education Institution Faculty Major Sub-Major GPA Period Remarks
High School SMKN 2 JIWAN 88.17 2024
Diploma
Bachelor
Master

2. What is your reason to choose the major in university ?

3. What is the title of paper that you have made (final paper, thesis, article, etc.) ?

4. Non-Formal Education
No Institution Course/Training Place Period Remarks
1
2
3

5. Foreign Language Capability :

Oral Writing
No Language
Poor Fair Good Poor Fair Good
1
2
3

C. EMPLOYMENT HISTORY

1. Work Experience
No Company Position Period Salary Reason of Resignation
1 CV. ILHAM INDUSTRI WAHANA PRODUKSI 3 BULAN 500.000 MASA PKL SELESAI
2 BUBUT AMIN 3 HELPER 3 BULAN - MASA PKL SELESAI
3
2. Give a brief explanation about your previous position (as mentioned before) :
- POSISI PRODUKSI MEMPUNYAI TUGAS UNTUK MENGHALUSKAN PERMUKAAN WAHANA DENGAN REMPELAS, MENYIAPKAN BAHAN
DAN ALAT SESUAI PERMINTAAN PEKERJA, MEMBERSIHKAN TEMPAT KERJA
- HELPER MEKANIK MEMPUNYAI TUGAS UNTUK MENYIAPKAN ALAT UKUR DAN BENDA KERJA, MEMBERSIHKAN BENGKEL

3. Named your superior and number of your sub-ordinate :

No Company Superior's Name Superior's Title Sub-ordinate

1
2
3

4. What is the most significant problems that you ever faced in work and how to solve it ?
BENDA KERJA RUSAK KEMUDIAN SAYA MENJELASKAN KELALAIAN SAYA DAN MEMINTA MAAF SAYA BERJANJI TIDAK AKAN
MELAKUKAN HAL YANG SAMA

5. How is your oppinion about the companies you have been worked for (as mentioned above) :
TEMPAT SAYA BEKERJA BAIK KARENA MEMILIKI LINGKUNGAN KERJA YANG SALING MEMBANTU DAN MENGERTI BATAS
KEMAMPUAN SESEORANG

6. Have you done any innovation or improvement in those companies ? Yes No

If yes, give a brief explanation :

7. How do you face a problem and make a decision in work ?

MENGHENTIKAN PEKERJAAN, MENGHUBUNGI ATASAN UNTUK MEMINTA ARAHAN, MENUNGGU DAN TIDAK MELANJUTKAN SEBELUM
ADA PERINTAH

8. Who motivate you to achieve your current condition ?

KELUARGA, KERABAT DAN GURU

D. FAMILY

1. Marital Status Single/Enggaged since **) :

Married since :
Divorce since :
**) cross unnecessary option

If Single, please complete

(Father, Mother, Siblings, including yourself)
Name Sex Place & Date of Birth Education Occupation
Father GURITNO LAKI-LAKI MAGETAN, 01-02-1977 TAMAT SLTA WIRASWASTA
Mother JAMIIS SHOLEKHAH PEREMPUAN MAGETAN, 29-10-1985 TAMAT SLTA WIRASWASTA
Child 1 FATCHAN RUZIQ AL F LAKI-LAKI MAGETAN, 16-08-2005 TAMAT SLTA BELUM/TIDAK BEKERJA
Child 2 RIDWAN ABDILLAH LAKI-LAKI MAGETAN, 27-10-2009 SMP BELUM/TIDAK BEKERJA
Child 3 WILDAN NUR K LAKI-LAKI MAGETAN, 17-03-2013 SD BELUM/TIDAK BEKERJA
Child 4
Child 5
Child 6
Child 7

If Married, please compelete

Name Sex Place & Date of Birth Education Occupation
Spouse
Child 1
Child 2
Child 3
Child 4
 Child 5

E. INTEREST & INDIVIDUAL CONCEPT

1. What is your goals and targets ?

SAYA INGIN TERUS BELAJAR HAL BARU TERUTAMA DI PT. KOMATSU INDONESIA INI, SAYA AKAN MELAWAN RASA MALAS AGAR BISA
BERKEMBANG DAN MEMBAWA KONSTRIBUSI POSITIF BAGI PERUSAHAAN

2. What motivate you to work ?

PT. KOMATSU INDONESIA MERUPAKAN INDUSTRI ALAT BERAT YANG TERBAIK, HAL INI MEMOTIVASI SAYA UNTUK BERKARIER
DI INDUSTRI INI

3. What is your reason for applying to our company ?

KARENA BUDAYA KERJA DI SINI SANGAT BAIK BISA JADI TEMPAT YANG TEPAT BAGI SAYA UNTUK MENGEMBANGKAN KARIER

4. How much is your expected salary ?

SETELAH SAYA MELAKUKAN RISET SAYA BERHARAP PERUSAHAAN MEMBERIKAN SAYA JUMLAH GAJI MINIMAL UMK

5. What kind of facilities are you hoping to be provided by our company ?

ASURANSI ATAU BPJS KESEHATAN, UANG TRANSPORTASI, KESEMPATAN UNTUK BELAJAR SKILL BARU

6. When is your availability to join with our company ?

13 JULY 2024

7. Based on your priority, choose the most suitable type of occupation (3 type) :
Type of Occupation Priority Type of Occupation Priority
Finance & Accounting Production Planning & Control
Information Technology Purchasing
Legal Warehouse
General Affairs Design
Office Administration or Secretary Production Engineering
Human Resources Production
Environment, Health & Safety Quality Assurance
Marketing Maintenance
Cost Control Others ***) :
***) please specify

8a. What kind of working environment do you like ?

Field Office Plant Others
Reason : SAYA NYAMAN BEKERJA DI LINGKUNGAN YANG SALING MENDUKUNG DAN SALING MENGHARGAI

8b. What kind of working environment you don't like ?

Field Office Plant Others
Reason : SAYA TIDAK NYAMAN BEKERJA DI LINGKUNGAN YANG MEMENTINGKAN DIRINYA SENDIRI

9. Are you willing to be placed outside the province ? Yes No

10. What kind of person do you like ?

ORANG YANG BISA BEKERJA SAMA DAN BISA DIAJAK BERKOMUNIKASI, DAN BISA BERTANGGUNG JAWAB DENGAN PEKERJAANNYA

11. For what kind of matters do you usually having trouble to make a decision ?
SAYA SULIT MENGAMBIL KEPUTUSAN ANTARA KULIAH DAN BEKERJA DENGAN MOTIVASI YANG SAYA DAPAT SAYA MEMILIH BEKERJA

F. SOCIAL ACTIVITIES

1. Do yo have any reference in our company ? Yes No

If yes, please named
No Name Position Telephone Relationship
 1
2

2. Named your reference (outside of our company) :

No Name Company Position Telephone Relationship
1
2

3. What is your hobby ?

SEPAK BOLA

4. How do you spend your free time ?

BERMAIN SEPAK BOLA BERSAMA TEMAN, MEMBACA AL QUR'AN DAN BERMAIN HANDPHONE

5. Organization followed :
No Organization Name Place Position Period
1 MARCHING BAND SMKN 2 JIWAN ANGGOTA 2021-2022
2 REMAJA MASJID DS. BLARAN ANGGOTA 2020-2024

G. OTHERS

1. Have you ever follow psychological testing before ? Yes No

If yes, please named
No Date Place Purpose
1
2

2. What is your strength ?

BERTANGGUNG JAWAB, PEKERJA KERAS, JUJUR, DISIPLIN, DAN MAU BELAJAR

3. What is your weakness ?

GUGUP, EMOSIAN DAN KURANG TEGAS

4. Have you ever suffer from a long time illness ? Yes No

If yes, please named
No Disease Period Physical Effects
1
2

5. Uniform information
Shirt L *) SS/S/M/L/XL
Pants 30 *) 28 - 38
Shoes 41 *) 36 - 45

6. Are you willing to selection process at jakarta? Yes No

I herewith declare that the above mentioned data is true. If any false data found, I agree to receive any sanction according to
regulation and the cancelation of this application.

Date :