Job Application Form: Form No: F-HR2-002 Rev. 2

JOB APPLICATION FORM
PERSONAL INFORMATION
Name : MIFTAHUL ULUM
Place / Date of Birth : Serang / 2002-02-02
ID Card Number : 3604050202020003
Address on ID Card :
0
Current Address : Kp. Lebak Sengge RT 004 RW 001

BANTEN
, Serang
:
Mobile Phone Number Home Phone Number :
081317570012
Email Address :
Office Phone Number :
[email protected]
Gender : Male Blood Type :B
Religion : Islam NPWP Number : 433740651454000
BPJS Kesehatan
: BPJS Ketenagakerjaan Number :
Number
Status : Single Nationality : Indonesia
Height : 166 cm Weight : 55 Kg
Sport / Hobbies : Football
In case of emergency : Muhtar Phone Number : 087771912761

who should we contact? Relationship : Child
FAMILY
Relationship Name Age Education Occupation Company/Institution

FORMAL EDUCATION
Degree Name & Location of Institution Major GPA Period Graduated
Senior
SMKN 2 KOTA SERANG, Jl. KH. ABdul Fatah Hasan No. Senior High School / Jun 2017 -
High 83 Yes
89 Kota Serang - Banten, Kota Serang, Banten Mechanical Engineering May 2020
School
NON FORMAL EDUCATION/TRAINING/COURSE/SEMINAR (Start with the most recent.)

Type of
Date / Period Certified
education/training/course/seminar
Pelatihan kerja BBPLK SERANG
PROGRAM PELATIHAN
1 month MIFTAHUL ULUM
OPERATOR KELISTRIKAN DAN
PNEUMATIK PLC
Desain Grafis 1 Month Miftahul Ulum
Form No: F-HR2-002 Rev. 2
ACADEMIC AND PROFESSIONAL ACTIVITIES AND ACHIEVEMENTS
Academic and professional activities, achievements, awards, publications, or technical-
Date/Period
professional communities. Indicate type or name
EMPLOYMENT HISTORY (Start with the most recent.)
Name & Address of

Company/Institution
Period (Month/Year) Entry: Exit:

Entry Position:
Position
Last Position:
Major Roles & Duties
Salary (Net) Entry: Last:
Other Benefits
Reason of Leaving
REFERENCES(list of referees who know your academic or professional performance, not

family member)
Name Address Phone Number Relation
SKILLS
Language (not your native language):
Reading Writing Speaking
Language
Poor Fair Good Poor Fair Good Poor Fair Good
Indonesia v v v
English v v v
Computer Skills
Autocad
Skechup
Microsoft Word
Microsoft Excel
Coreldraw x7
Other Skills
Lathe Machine
CNC Machine
Frais Machine
PREFERENCE OF PROFESSION
Accounting Finance Marketing
Sales Supply Chain MIS
Human Resources Production Engineering
R&D/QA Other :
PREFERENCE OF INDUSTRY
Manufacturing Financials Property
Natural Resources Retail & Trading Other :
SALARY EXPECTATION
IDR 0
ADDITIONAL INFORMATION
Have you ever applied to PT Gajah Tunggal Tbk before?
No
If yes, when?
Company:
Do you have any special medical condition?
No
If yes, please explain:
Other companies outside PT Gajah Tunggal Tbk you are applying to:
Yes, if I am not accepted here, I have other options, because this is for the sake of my future career. but I really hope
that I can be accepted here at PT Gajah Tunggal tbk
List of friends or relatives now employed by PT Gajah Tunggal Tbk:

Name Position Relationship
ESSAY
Please think about yourself and answer these questions:
1. What is your goals in life?
2. Please mention your strength and weaknesses!
3. What do people think or say about you?
4. Other information that you would like to share which may be helpful in considering your qualifications and interests.
1. health, by having good health conditions can work optimally and can produce maximum results too. My target is to
become an expert in this field of work by studying all aspects in the first 3 years and after that I am given the
responsibility of this position.
2. My strength is that I am committed to work, I got this when I was street vendors and worked. and my weakness is
lack of experience in working on this position, but I want to learn to catch up with me in this position.
3. I am a hard worker and have a good contribution
4. I'm waiting for further information, thank you
PLEASE READ THIS STATEMENT CAREFULLY
I hereby confirm that the information given by me on this Job Application Form is accurate. I understand that any
falsification will be considered as a sufficient cause for dismissal. I authorize PT Gajah Tunggal Tbk to do a thorough
investigation in regards of this application concerning my personal information, education background, employment
history and any breach of rules.
________________________ _____/_____/________
Name & Signature Date
Thank you for taking time to complete this application

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JOB APPLICATION FORM

ID Card Number : 3604050202020003

Current Address : Kp. Lebak Sengge RT 004 RW 001

In case of emergency : Muhtar Phone Number : 087771912761

NON FORMAL EDUCATION/TRAINING/COURSE/SEMINAR (Start with the most recent.)

EMPLOYMENT HISTORY (Start with the most recent.)

Name & Address of

Period (Month/Year) Entry: Exit:

Major Roles & Duties

Salary (Net) Entry: Last:

REFERENCES(list of referees who know your academic or professional performance, not

List of friends or relatives now employed by PT Gajah Tunggal Tbk:

Please think about yourself and answer these questions:

1. What is your goals in life?

2. Please mention your strength and weaknesses!

3. What do people think or say about you?

Thank you for taking time to complete this application

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