Scribd
Upload
27 views6 pages

Application Form Updated

This document is an application form for employment that collects personal details, education history, work experience, references, and salary requirements from the applicant. It requests information including the applicant's full name, date of birth, address, family details, health history, formal education background, training and certifications, work experience at four previous companies, salary and benefits from previous roles, two professional references, desired salary, and earliest start date. The form is to be signed and dated by the applicant and includes sections for remarks and approval from the hiring company's Director of Human Resources and relevant Department Head.

Uploaded by

Fransiskus Asisi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
27 views6 pages

Application Form Updated

This document is an application form for employment that collects personal details, education history, work experience, references, and salary requirements from the applicant. It requests information including the applicant's full name, date of birth, address, family details, health history, formal education background, training and certifications, work experience at four previous companies, salary and benefits from previous roles, two professional references, desired salary, and earliest start date. The form is to be signed and dated by the applicant and includes sections for remarks and approval from the hiring company's Director of Human Resources and relevant Department Head.

Uploaded by

Fransiskus Asisi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
You are on page 1/ 6

APPLICATION FORM

CONFIDENTIAL
USE CAPITAL LETTERS
Position applied for :

I.

Photo 4x6

PERSONAL DATA
A. Personal Details
Full Name:
Place of Birth:

Sex:
Religion:

Date of Birth:

Home Address & phone

Identity Card No.

Marital Status:
- Married
- Single
- Others

Hand phone :
E-mail :

Office phone:

B. Family Details
(Spouse and children)
Name

M/F

Age

Education

Job

Company

C. Family Details
(Father, mother, brothers/sisters including you)
Name
M/F

Age

Education

Job

Company

Spouse
Child 1
Child 2
Child 3

Father
Mother
Bro./Sis. 1
Bro./Sis. 2
Bro./Sis. 3
D. Health History
1. Have you had a rather severe illness/accident?
If yes, please describe

Month/Year

2. Does it have a side effect presently ?


If yes, please describe

II. EDUCATION AND SKILLS


1

A. Formal Education
Education
High School

Schools Name

Major

From / To

GPA

Academy
University

B. Non Formal Education : Course/Training/Seminar


Subject

Provider

Year/Period

Paid by

1.
2.
3.
C. 1. Scientific publication including thesis

2. Extra curricular / Social / Teaching Activities


Name of Activities / Organization

Position

Year/Period

1.
2.
3.
D. Languages (fluent/slight)
Fluent

Listening
Fair
Slight

Fluent

Speaking
Fair Slight

Fluent

Writing
Fair

Slight

1. English
2.
3.
E. Hobbies/sports

F.

Scholarship/awards/prizes received :

III. WORK EXPERIENCE


(Four latest experiences, others please attach on separate page)
Month

Year

Name/Address/Phone of Company

Position

Fr.:

First :

To

Last :

Type of Business :

Total Employees:

Name of Supervisor :

Name of Director :

Major Tasks & Responsibilities

Major achievements

No. of employees supervised:

Directly :

Indirectly:

Major reason for change :


Minor reason for change:

Month

Year

Name/Address/Phone of Company

Position

Fr.:

First :

To

Last :

Type of Business :

Total Employees:

Name of Supervisor :

Name of Director :

Major Tasks & Responsibilities

Major achievements
No. of employees supervised: Directly :

Indirectly:

Major reason for change :


Minor reason for change:

Month

Year

Name/Address/Phone of Company

Position

Fr.:

First :

To

Last :

Type of Business :

Total Employees:
3

Name of Supervisor :

Name of Director :

Major Tasks & Responsibilities

Major achievements

No. of employees supervised: Directly :

Indirectly:

Major reason for change :


Minor reason for change:

Month

Year

Name/Address/Phone of Company

Position

Fr.:

First :

To

Last :

Type of Business :

Total Employees:

Name of Supervisor :

Name of Director :

Major Tasks & Responsibilities

Major achievements

No. of employees supervised: Directly :

Indirectly:

Major reason for change :


Minor reason for change:
IV. SALARY & BENEFIT HISTORY
(Starting From Current / Latest Company)
1. Company Name :

2. Company Name :

Basic Net Salary :

Basic Net Salary :

Allowances (Transport, Meal, etc) :

Allowances (Transport, Meal, etc) :

Bonus/Commision :

Bonus/Commision :
4

Benefit (Medical, etc) :

Benefit (Medical, etc) :

3. Company Name :

4. Company Name :

Basic Net Salary :

Basic Net Salary :

Allowances (Transport, Meal, etc) :

Allowances (Transport, Meal, etc) :

Bonus/Commision :

Bonus/Commision :

Benefit (Medical, etc) :

Benefit (Medical, etc) :

V. PROFESIONAL REFERENCES
1. Full Name :

2. Full Name :

Company :

Company :

Address :

Address :

Relationship :

Relationship :

Phone :

Phone :

VI. SALARY AND COMMENCEMENT OF EMPLOYMENT


1.
2.

Desired nett monthly salary?


Earliest date able to commence employment

I hereby declare that every statement given by me in this form is true, correct and given voluntarily. I authorize the
Management to submit the said information to any person or organization for the purpose of any investigation which the
Management may desire to make. I agree that if any false declaration is made by me, my agreement may be terminated
without notice.

Jakarta,

2016

For official use only:


Remarks by Director of Human Resources:

Signature:

Date:

Remarks by Department Head:

Signature:

Date:

Selected Candidate (For HR Department)


Position: ______________________________________ Headcount:
_____________________________
Start Date: ____________________________________ Level:
__________________________________
Contract / Permanent: _________________________ Report to:
_______________________________

Other Comments :

You might also like