APPLICATION FOR EMPLOYMENT

I. Position Applied  IT Sales Executive

   
II Personal Particulars  
2.1 Full Name  Ahmad Sirojuddin Achyadi
2.2 Permanent Address  Jl. Primer No. 3 Cibadak sukabumi
2.3 Correspondence Address  Cluster Whelford fc1 no 1 Bsd City Tanggerang
2.4 Contact Number Home : Mobile:0857 5911 7449
2.5 E-mail Address  [email protected]
2.6 Date of Birth  24, july 1981
2.7 Nationality  Indonesian
2.8 Languages  Indonesian
2.9 Interest and Hobbies  Cooking, reading, gaming

III. Employment History

Salary
Period
Reason for Leaving
Name of Employer Position From To Last Drawn
Starting
(mm/yy) (mm/yy) / Current
PT. Mitra Integra Project 02- 3-2009 1.000.00 3.000.000 Better Opportunity
Telematic Manager 2003 0
Drs samsudin Trainer 04- 07-2011 14.000.0 14.000.000 Starting own
2009 000 business
Primerspot Internet Cafe owner 2009 now 15.000.0 Nil
00

3.1. May we contact your employers? : *Yes / No / NA

3.2. Have you previously applied to us? : *Yes / No / NA
If Yes what position :
3.3. Are you related to any of our existing employees? * Yes / No. If yes, please elaborate:
3.4. Is your existing employer a customer / client / partner of TÜV SÜD? *Yes / No / NA / Unsure
3.5. Do you have an existing employment contract, which requires you to make payment to another party, if you join
us (i.e. under a bond)? : *Yes / No
If yes, please elaborate :

IV. Remuneration
No Detail Monthly (IDR) Annual (IDR)
4.1 Last/Current  14.000.000  
Salary
4.2 Expected Salary  6.000.000  
4.3 Last Increament NIL  
4.3 Other Benefit Remark Amount (IDR)
 a. Jamsostek  NIL  
 b. Medical  NIL  
Others (if any)
 c. please specify NIL  

TAP-HR-F-02
Rev.00
2013.09.23 Private & Confidential
 V. Education
From To
Highest Qualification Attained
School/College/Polytechnic/University (mm/yy) (mm/yy)
PADJADJARAN UNIVERSITY 1999 2003

VI. Technical Qualification

No Detail Technical Qualification Institution (e.g IRCA, IEMA, etc) Since (mm/yy)

1  NA    
2  NA    
3  NA    
4  NA    
5  NA    

VII. Industry Experience

No Detail Industry Experience Experience source from Number of year

1  NA    
2  NA    
3  NA    
4  NA    
5  NA    

VIII. Relevant Training/Courses

Training/Course Qualification
No. Courses Institution/School
Duration (days) Attained
1  NA      
2  NA      
3  NA      
4  NA      
5  NA      

IX. Professional Membership

Level of
No. Club/Society Position From/To Participants
(National/School)
1  NA      
2  NA      
3  NA      
4  NA      
5  NA      

X. Family Particular [Spouse and children OR parents and siblings]

TAP-HR-F-02
Rev.00
2013.09.23 Private & Confidential
 Relationship to
No. Name Age Occupation Name of Employer
Applicant
1 TINI KUSTINI MOTHER 67 HOUSEWIFE NA
2 HERNI RIANI SISTER 43 HOUSEWIFE NA
3 ABDUL HADI BROTHER 34 VICE PRESIDENT CityBank
4
5

XI. Declaration

a. I *have / have not been suffering from any physical impairments or illness.
If you have, please elaborate:

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

c. I *have / have not been put in a situation of financial embarrassment.

If you have, please elaborate:

I declare that the information furnished in this application form 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 investigation or verification which the company deems 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, costs and expenses of any
nature arising from the release of such information as aforesaid.

Signature of Applicant:_____________________________________ Date:_ 12 – 10 - 2018_____________

Notes
1. Please complete this form and return to Human Resources Department of TUV SUD Indonesia
2. Complete each item in the form which applies to you and insert the words ‘NIL’ or ‘NA’ against items which do not
3. apply to you. Delete accordingly for items accompanied by an asterisk (*).
4. If space provided is insufficient, please attach separate sheets. Each sheet must bear your name
5. Please attached supporting documents as follows:
a.Copy of your ID Card (KTP)
b.All educational, academic and professional certificates & transcripts
6. We may request for references from applicants during the selection process.

TAP-HR-F-02
Rev.00
2013.09.23 Private & Confidential