form personal data (jind)

8/19/2019 Form Personal Data (JIND)

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STRICTLY CONFIDENTIAL

(To be filled in by JIND Officer)

Number :

PERSONAL RECORD

PT. JGC IndonesiaJGC Building

TB Simatupang 7-BJakarta 12430

Phone : (62-21) 29976500Fax : (62-21) 29976599

Website : http://www.jgc-indonesia.come-mail : [email protected]



To Applicant : We deeply appreciate your interest in our organization

We need a clear understanding of your background andwork history in orienting you to the position that bestmeets your qualifications and may assist us in possiblefuture development.

PHOTO (3x4)

PERSONAL DATA

Full Name :

Name Occupation Date of Birth Place

Spouse (Wife/Husband) :

Date

Present Address :

Permanent Address :

Religion :

Sex :

Marital Status :

Children :

No Name Sex Date of Birth Place1

2

3

4

5

Parents :

Name Sex Date of Birth Occupation PlaceFather's

Mother's

Brothers - Sisters :

1

2

3

4

5

6

Business

Telephone :

Home

Mobile

E-mail Address :

Passport No. (if any) :

Place & Date of Birth :

Belonging to :

Belonging to :NPWP :

Personal Identity (KTP/SIM) :

Correpondence to :

Blood Type :

Expire Date :

Expire Date :

Penn Mul ani

Jan 20 2016

Jl. Sawo No. 27 RT.007 RW.002 No.27

Ciman is De ok

Jl. Sawo No.27 RT.007 RW.002 No.27

Ciman is De ok

Islam

Female

Sin le

Bunaedi August 3, 1958 Retired Depok

Kasih November 19, 1963 House Wife Depok

Ridho Tri Utomo Male August 25, 1994 Student Depok

021 8774 3790

08211 35 3737 6

mul ani enn @ mail.com

A3808955

Bo or 11 02 89

Famil

Famil

24.284.631.9-412.000

3276025102890004

Permanent Address

A

24 SEP 2017

11/02/2017



EMERGENCY CONTACT

(Mandatory to be Filled)

Please list the people you would like to be notified in case of emergency

Present Address :

Full Name :

Relationship :

Mobile

Home

Telephone :

Mobile

Home

Telephone :

Present Address :

Relationship :

Full Name :

1.

2.

Sukama u Baru Cilodon De ok

Jl. Mawar III RT.03 RW.06 No.42

Ika Rubbi anti

Sister

0821 4241 4412



WORK INTEREST

Position applied for :

Other position(s) for which you consider to be qualified :

or

Would you agree to work in remote area or developing country ?

EDUCATION BACKGROUND

School From - To Name of School Location Majoring Title Degree Given GPA

Sr. High

Academy

University :

- Bachelor

- Master

- PhD

FOREIGN LANGUAGE SKILLS

No LANGUAGE Read Write Speak 1 English

2 Indonesia

3 Japan

4

TRAINING/COURSE RECORDS

Subject of Training From - To Organized by Location1

2

3

4

5

6

Would you agree to change your profession ?

Monthly Salary expected ?

Why did you choose this position :

Media Used for applying job :

YEAR TOEFL Score :

YEAR TOEIC Score :

Secretar

in the area of administrative o erations such as secretarial duties.

Procurement Staff HRD Staff

Yes

2004-2007 SMK Tunas Harapan Jakarta Analis Laboratory - -

2009-2013 Pancasila Universit Jakarta HR Mana ement S.E 2.98

Excellent Excellent Excellent

Excellent Excellent Excellent

Yes

Nett THP Exlcude Ta 6.000.000

One of m reatest as irations is to achieve carreer success

Com an Web



List all present and past employment records, starting with the most recent one.

EMPLOYEMENT RECORDS

Use separate block for each employment.

Period to1.

Company

Starting position

Current position

Salary

Number of employees supervised (if any) :

Brief description of activities (in the last position) :

City

Type of Business

:

:

:

:

:

:

:

Current Status :

What Projects have you been handled ?

NO PROJECT NAME LOCATION CLIENT YEAR

Period to2.

Company

Starting position

Current position



City

Type of Business

:

:

:

:

:

:

:

:



Salary

Current Status

2016

PTI Architects

Secretar of Director

Secretar of Director

Gross Include Tax

Su ortin director with secretarial duties - Or anizin all event conducted b com anPre arin RFP document for tender - Monitorin man hour based on runnin ro ects

Com ile man hour data for monthl re ort - etc.

Architectural & Interior Desi n Services

Consultant

Permanent

4.750.000

2010



List all present and past employment records, starting with the most recent one.

EMPLOYEMENT RECORDS

Use separate block for each employment.

Period to3.

Company

Starting position

Current position



City

Type of Business

:

:

:

:

:

:

:

Current Status :



Period to4.

Company

Starting position

Current position



City

Type of Business

:

:

:

:

:

:

:

Current Status :



Salary

Salary



Membership of Professional Association :

ACTIVITIES & HOBBIES

Hobbies & Sports :

Social Activities :

PERSONAL REFERENCES (Former Employers or Lecturers)

NameOccupation

Address

Name

Occupation

Address

HEALTH

Details of Seriuos illness : YES NO

ADDITIONAL INFORMATION (if Any)

The facts stated in this application for employment are true and complete to the best of my knowledgeand belief.I understand that false information in this application shall be considered sufficient for dismissal fromemployment.

Date : Applicant's Signature :

Please supply documentary evidence which supports the statements you have madeabove. Do not, in any event, submit the originals of references, testimonials, certificatesor diplomas, unless they have been obtained for the sole use of PT. JGC Indonesia.

Photographs and documents are non returnable and shall thereafter be deemed to bethe property of PT.JGC Indonesia

N.B :

::

:

:

:

:

Travelin Readin Runnin & Yo a

January 20, 2016

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