formulir identitas pribadi
TRANSCRIPT
8/20/2019 Formulir Identitas Pribadi
http://slidepdf.com/reader/full/formulir-identitas-pribadi 1/6
PT. Adis Dimension Footwear
No Doc : Form/HRD-02/03 Effective Date : November 01st 2015
Revisi : 1
P a g e 1
FORMULIR DATA PRIBADI
Personal Data Form
Jabatan yang diharapkan :
Expected Occupation :
C A T A T A N :
Remarks :
a. Isilah dengan huruf cetak
Fill in with block letter
b. Bila keterangan yang diberikan dibawah ini tidak sesuai dengan kenyataan, di kemudian hari Perusahaan berhak memutuskan
hubungan kerja atau menuntut karyawan sesuai hukum yang berlaku.
If the information provided is proven to be incorrect, company has the right to terminate employment or sue the employee
according to the appropriate law
A.IDENTITAS :
Identity
Nama lengkap : ………………………………………………………………………………………………………
Full NameTempat / tanggal lahir : ……………………………………………………………………………………………………….
Place / Date of Birth : ……………………………………………………………………………………………………….
Alamat : ...…………………………………………………………………………………………………….
Address
(Tetap / Sementara ) : ………………………………………...Telp. No.: …………………HP No : ..…………………….
(Permanent /temporary) Phone No : Mobile Phone:
Alamat lainnya : ……………………………………………………………………………………………………….
Other Address
: ………………………………….…….Telp. No.:…………………………………………………..
Phone No.
Kewarganegaraan : …………………….……………….
Nationality
K T P No. : …………………………………………. Dikeluarkan di : ……………………………………….
ID Card No. Place of issue
Tanggal berlaku s.d : …………………………………………
Valid UntilS. I. M A/B/C : ………………………………………… Berlaku s/d : ……………………………………….
Driving License No Valid Until
B. KELUARGA DAN LINGKUNGAN
Family and Society
1. Status Pernikahan : - Single / Bertunangan sejak tanggal : …………………………………………………………..
Marital status Single / Engaged since
- Menikah sejak tanggal : …………………………………………………………..
Married since
- Bercerai sejak tanggal : …………………………………………………………. Divorce since
2. Susunan Keluarga ( Istri / Suami dan anak – anak )
Family order (Wife/Husband and children)
NAMA
Name
L / P
M/F
Tempat / Tgl. Lahir
Place/Date of Birth
Pendidikan
Education
Pekerjaan
Occupation
Istri / Suami
Wife/Husband
Anak 1
First Child
Anak 2
2nd Child
Anak 3
3rd Child
Anak 4
4th Child
(Bila sudah meninggal dunia sebutkan pendidikan dan pekerjaan ketika masih hidup)
(If already passed away, please state education and occupation during alive)
8/20/2019 Formulir Identitas Pribadi
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PT. Adis Dimension Footwear
No Doc : Form/HRD-02/03 Effective Date : November 01st 2015
Revisi : 1
P a g e 2
3. Susunan Keluarga ( Ayah, Ibu dan Saudara )
Family order (Father, Mother, Brother and Sister)
NAMA
Name
L / P
M/F
Tempat / Tgl. Lahir
Place/Date of Birth
Pendidikan
Education
Pekerjaan
Occupation
AyahFather
Ibu
Mother
Anak 1
First Child
Anak 2
2nd child
Anak 3
3rd Child
Anak 4
4th
Child
Anak 5
5th Child
Anak 6
6 th Child
Anak 7
7 th Child
Anak 8
8 th
Child
(Bila sudah meninggal dunia sebutkan pendidikan dan pekerjaan ketika masih hidup )
(If already passed away, please mention education and occupation during alive)
4. Apakah rumah yang Saudara tempati tersebut :
Is your current house :
Rumah pribadi r Rumah orang tua Rumah keluarga suami / istri Rumah yang dikontrak
Own House Parents’ House Family House Rental House
Rumah pondokan/ kost ( Biaya Pemondokan Rp……………… ) Biaya Rp. ……………..
Boarding House (Cost Rp……………… ) Cost Rp. ………………..
5. Sebutkan 2 – 3 nama diluar hubungan keluarga yang dapat kami hubungi / tanyai mengenai Saudara ( Pengalaman, karakter,dsb.) setiap waktu :
Mention 2 - 3 names outside family who can be contacted to know more about you ( Experience, character Etc.) anytime :
NO.
No
NAMA
Name
PEKERJAAN/JABATAN
Occupation
NO. TELPON
Phone No
1
2
3
C.RIWAYAT PENDIDIKAN SEJAK SLTA
History Education from High School
NO
No.
NAMA SEKOLAH
Name of School
JURUSAN
Major
DARI S/D TAHUN
From Until
TEMPAT / KOTA
City
1
2
3
4
5
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No Doc : Form/HRD-02/03 Effective Date : November 01st 2015
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NO.
No
KURSUS/ TRAINING YANG PERNAH DIKUTI
Courses/Training
TEMPAT
Place
DARI / SAMPAI THN
From/Until Years
KETERANGAN
Remarks
1
2
3
4
1. Apakah yang menyebabkan Saudara memilih pendidikan jurusan tersebut ?
Why did you choose this major of education ?
…………………………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………………………….2. Tulis karya Ilmiah Saudara ( Skripsi, artikel, buku, dll )
Write your science task during your education (Thesis, Article, Book, Etc)
a . ………………………………………………………………………………………………………………………………..
b . ………………………………………………………………………………………………………………………………..
c. ………………………………………………………………………………………………………………………………..
3. Mata pelajaran apakah yang paling Saudara senangi ? Berapa nilai rata – ratanya ? What subject do you like most? What is the average score?
……………………………………………………………………………………………………………………………………4. Siapa yang selama ini membiayai pendidikan Saudara ?
Who pay your education cost?
…………………………………………………………………………………………………………………………………….
5. Penguasaan Bahasa Asing
Foreign Language competency
BAHASA
Language
TERTULIS
Writing
LISAN
Listening
KETERANGAN
Note
S CB B S CB B S : Sedang / Average
CB : Cukup Baik / Good Enough
B : Baik / Very Good
D. PEKERJAAN
Occupation
1. RIWAYAT PEKERJAAN
1.1 Nama perusahaan : …………………………………………………………………………………………..
Company name
Dari s/d tahun : …………………………………………………………………………………………..
From – Until (years)
Jabatan : …………………………………………………………………………………………..
Position
Gaji : …………………………………………………………………………………………..
Salary
Uraian singkat pekerjaan : …………………………………………………………………………………………..
Brief description of work
…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
Nama atasan : …………………………………………………… Jumlah bawahan : …………………
Superior Name Total Subordinates
Alasan berhenti : …………………………………………………………………………………………..
1.2. Nama perusahaan : …………………………………………………………………………………………..
Company name
Dari s/d tahun : …………………………………………………………………………………………..
From – Until (years)
Jabatan : …………………………………………………………………………………………..
Position
Gaji : …………………………………………………………………………………………..
Salary
Uraian singkat pekerjaan : …………………………………………………………………………………………..
Brief description of work
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PT. Adis Dimension Footwear
No Doc : Form/HRD-02/03 Effective Date : November 01st 2015
Revisi : 1
P a g e 4
……………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………
Nama atasan : …………………………………………………… Jumlah bawahan : …………………
Superior Name Total Subordinates
Alasan berhenti : …………………………………………………………………………………………..
Reason to leave
1.3. Nama perusahaan : …………………………………………………………………………………………..
Company name
Dari s/d tahun : …………………………………………………………………………………………..
From – Until (years)
Jabatan : …………………………………………………………………………………………..
Position
Gaji : …………………………………………………………………………………………..
Salary
Uraian singkat pekerjaan : …………………………………………………………………………………………..
Brief description of work
……………………………………………………………………………………………………………………………..…………………………………………………………………………………………………………………………..
Nama atasan : …………………………………………………… Jumlah bawahan : …………………
Superior name Total Subordinates
Alasan berhenti : ………………………………………………………………………………………….. Reason to leave
3. Masalah – masalah penting apa saja yang pernah Saudara hadapi dan bagaimana Saudara mengatasinya ?
What kind of important problems did you face and how did you solve it?
……………………………………………………………………………………………………………………………………….
……………………………………………………………………………………………………………………………………….
……………………………………………………………………………………………………………………………………….4. Pernahkah Saudara melakukan perubahan / pembaharuan di perusahaan – perusahaan terdahulu ? Ya/Tidak
Did you ever make any changes/improvement in your previous company?
Perubahan / Pembaharuan apa yang Saudara lakukan ?
What kind of changes/improvement did you make?
..………………………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………………….
……………………………………………………………………………………………………………………………………….
5. Puaskah Saudara terhadap kemajuan yang Saudara capai pada pekerjaan – pekerjaan terdahulu ? Mengapa ?
Do you satisfy with your own achievement progress during your previous job? Why ?
……………………………………………………………………………………………………………………………………….
……………………………………………………………………………………………………………………………………….
6. Menurut pendapat Saudara, apa dan siapa yang paling utama mendorong Saudara hingga sampai pada taraf kemajuan seperti
sekarang ?
According to you, what and who supported you to achieve your current progress ?
……………………………………………………………………………………………………………………………………….
……………………………………………………………………………………………………………………………………….
7. Bila Saudara menghadapi persoalan dalam pekerjaan dan harus mengambil keputusan, apa yang Saudara lakukan ?
If you are facing the problem in your work and have to take a decision, what will you do ?
……………………………………………………………………………………………………………………………………….
……………………………………………………………………………………………………………………………………….
8. Bila Saudara menghadapi persoalan pribadi / pekerjaan dengan siapakah biasanya Saudara berunding ?
If you are facing personal or work problem, with whom will you discuss?
……………………………………………………………………………………………………………………………………….
……………………………………………………………………………………………………………………………………….
E. MINAT DAN KONSEP PRIBADI
Interest and personal concept
1. Faktor – faktor apa saja yang menyebabkan Saudara ingin bekerja ? What factors make you want to work?
………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………
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PT. Adis Dimension Footwear
No Doc : Form/HRD-02/03 Effective Date : November 01st 2015
Revisi : 1
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2. Mengapa Saudara ingin bekerja di Perusahaan kami ?
Why do you want to work in our company?
………………………………………………………………………………………………………………………………………
3. Apa yang Saudara ketahui mengenai Perusahaan kami ?
What do you know about our company?……………………………………………………………………………………………………………………………………….
……………………………………………………………………………………………………………………………………….
4.Berapa gaji minimal yang Saudara inginkan ?
What is your minimum salary expectation?
……………………………………………………………………………………………………………………………………….
5. a. Fasilitas – fasilitas yang diinginkan disamping gaji :
Facilities expected besides salary
………………………………………………………………………………………………………………………………………..
b. Kapan Saudara mulai dapat bekerja ?
When will you ready to start working ?
……………………………………………………………………………………………………………………………………….
6. Pilih jenis pekerjaan berikut sesuai dengan prioritas pekerjaan yang Saudara minati ( 3 jenis )
Choose kinds of job priority related to your interest (Min 3 kind of job)
JENIS PEKERJAAN
Kind of Job
NO. URUT
Priority
JENIS PEKERJAAN
Kind Of Job
NO. URUT
Priority
Production HR / CR
Engineering / Maintenance Marketing / Export
Development / PCC Laboratories
PPIC ( Planning, Production &
Inventory Control)Finance & Accounting
IT (Information Technology)
Purchasing
Quality
Industrial Engineering
Product Engineering Others :
7. Apa yang Saudara lakukan untuk menduduki jabatan yang Saudara inginkan ? What do you do to achieve your job goal ?
………………………………………………………………………………………………………………………………………...
8. Lingkungan pekerjaan yang Saudara senangi : Pabrik / Kantor / Lapangan / Laboratorium. Mengapa ? Work environment preference: Factory / Office / Plant / Laboratory and why ?
……………………………………………………………………………………………………………………………………….
9. Lingkungan pekerjaan yang paling tidak Saudara senangi : Pabrik, / Kantor / Lapangan / Laboratorium. Mengapa ?
Work environment less preference: Factory / Office / Plant / Laboratory and why ?
.……………………………………………………………………………………………………………………………………..
10. Bersediakah Saudara ditempatkan diluar daerah ?
Are you ready to be placed outside the region?
…………………………………………………………………………………………………………………………………….….
11. Apakah cita – cita hidup Saudara ? What is your life goals?
………………………………………………………………………………………………………………………………………..12.Apa rencana Saudara untuk mencapai cita – cita tersebut ?
What is your plan to achieve your goals?
………………………………………………………………………………………………………………………………………...
………………………………………………………………………………………………………………………………………...13. Tipe orang yang bagaimana yang paling Saudara senangi ?
What kind of people do you like most ?
………………………………………………………………………………………………………………………………………...
14. Tipe orang yang bagaimana yang tidak Saudara senangi ?
What kind of people do you like less ?
………………………………………………………………………………………………………………………………………...
15. Terhadap hal – hal apakah Saudara paling sulit untuk mengambil keputusan ?
What kind of things most difficult for you to decide ?………………………………………………………………………………………………………………………………………..
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PT. Adis Dimension Footwear
No Doc : Form/HRD-02/03 Effective Date : November 01st 2015
Revisi : 1
P a g e 6
F. AKTIFITAS DAN KEGIATAN - KEGIATAN LAIN
Other activities
1. Sebutkan nama kenalan Saudara di Perusahaan kami (di luar hubungan keluarga)
Please mention names that you know in our company (Outside family relation)………………………………………………………………………………………………………………………………………
2. Siapakah Referensi Saudara di luar Perusahaan kami (di luar hubungan keluarga)
Who is your reference outside our company (Outside family relation)
………………………………………………………………………………………………………………………………………3. Apakah hoby / kegemaran Saudara ?
What is you hobby ?
……………………………………………………………………………………………………………………………………….
4. Bagaimana Saudara mengisi waktu luang Saudara ? How do you spend your spare time ?
……………………………………………………………………………………………………………………………………
5. a. Surat kabar, majalah atau buku – buku apakah yang Saudara baca ?
Newspaper, magazine, books, that you used to read?
…………………………………………………………………………………………………………………………………
b. Pokok – pokok / topik - topik apakah yang paling Saudara senangi ? What kind of topic that you are interested in?
…………………………………………………………………………………………………………………………………
6. Apakah Saudara pernah keluar negeri, kapan dan untuk keperluan apa ?
Have you ever been went abroad, when and for what purpose ?
………………………………………………………………………………………………………………………………………
7. Apakah Saudara memiliki kendaraan ? sebutkan !
Do you have a personal vehicle? Please mention it!
………………………………………………………………………………………………………………………………………
8. Organisasi – organisasi apakah yang pernah Saudara masuki ? Apakah jabatan Saudara di organisasi tersebut ? Berapa lama? What kind of Organization that you have ever joined? What was your position? How long have you been there ?
………………………………………………………………………………………………………………………………………
G. LAIN – LAIN
Others1. a. Faktor – faktor apakah yang Saudara rasakan sebagai kelebihan (Strong Point) bagi diri Saudara ?
What do you think to be your strength points ?
…………………………………………………………………………………………………………………………………
b. Faktor – factor apakah yang Saudara rasakan sebagai kekurangan ( Weak Point ) bagi diri Saudara ?
What do you think to be your weakness points?
…………………………………………………………………………………………………………………………………
2. Apakah Saudara pernah menderita sakit yang lama sembuh ?
Have you ever been in long and serious sickness?
………………………………………………………………………………………………………………………………………
3. Apakah ada gangguan jasmani yang tetap/sering mengganggu Saudara ? Sebutkan ! Is there any physical handicap bothering you a lot? Please mention !
………………………………………………………………………………………………………………………………………
4. Apakah ada keluarga Saudara yang sering mendapat gangguan kesehatan ? Sebutkan !
Is there any member of your family having health problem ? Please mention !
………………………………………………………………………………………………………………………………………
Balaraja, ……………………………………….
Diisi dengan sesungguhnya.
All above data filled in truth
( ………………………………………….)