PT ARASAINS

Please attach a
Employment Application recent photograph
here
Please answer all the questions accurately as any false information will disqualify you from employment.

PERSONAL PARTICULAR
Position Applied For For official Use
Company:
Full Name KTP. No. Date of Birth Sex

Marital Status Ethnic Religion Nationality

Present Address

Permanent Address

Email Address

Home Phone Handphone No. Weight

BPJS No. NPWP. Height

Do you own a car? Yes / No If Yes, please state licence No.

FAMILY PARTICULARS
Name – Parents, Brothers & Sisters Age Company Name / Occupation Contact No.

If Married, Particular of Spouse & Children

Spouse’s Name NRIC No. Income Tax No.

Company Name Position Contact No.

No. of Children Age Of Children

( )_____ ( )_____ ( )_____

LANGUAGE PROFICIENCY– State ‘Good’, ‘Fair’, or ‘Poor’

Language
(Specified)
Speak
Read
Write
EDUCATIONAL PARTICULARS
Level Institution Course From To Grade
Secondary
High School
College / University

Additional

Detail of other Education and Training

Year Name / Nature of Course Name / Place of Training

DETAIL OF MEMBERSHIP WITH PROFESSIONAL INSTITUTION ( IF ANY )

Name of Professional Institutions Year Membership Grade

PARTICULAR OF WORKING EXPERIENCE

Detail of Present Employment (if any)

Company Name: Tel:

Address:

Position: Started From: _________________to__________________

Present Job Responsibilities:

Basic Salary and Bonus:

Reason For Leaving:

Detail of Past Employment

(1) Company Name Started From: _________________to__________________

Position: Last Drawn Basic Salary:

Main Duties:

Reason For Leaving:

(2) Company Name Started From: _________________to__________________

Position: Last Drawn Basic Salary:

Main Duties:

Reason For Leaving:

(3) Company Name Started From: _________________to__________________

Position: Last Drawn Basic Salary:

Main Duties:

Reason For Leaving:

(4) Company Name Started From: _________________to__________________

Position: Last Drawn Basic Salary:

Main Duties:

Reason For Leaving:

(5) Company Name Started From: _________________to__________________

Position: Last Drawn Basic Salary:

Main Duties:

Reason For Leaving:

REFERENCES
Give the name of two persons not related to you, whom you have known not least one year.
Name Company Name Occupation Relations Tel No.

GENERAL INFORMATION
(Please Tick) Yes No
Would you object to overseas assignment?
If Yes, please explain:
Are you bonded by your present company / school or the government?
If Yes, please state total amount:
Have you been, or are you, suffering from any personal impairment, illness, medical or mental condition?
If Yes, please elaborate:
Have you ever been discharged or dismissed from service of past employers?
If Yes, please explain:
Have you ever been convicted in a court of law in any country?
If Yes, please explain:
Do you know anyone presently employed by the company?
If Yes, please state
Name: Relationship: Dept: Position:
Length if Notice Required Date Available Expected Salary

DECLARATION
I declare that the particular in this application form and any documents attached are true to the best of my knowledge and that I have not willfully
suppressed any material fact. I also understand that if after employment, it is found that I have deliberately made a false declaration in this
application, it may lead to my dismissal from service.

Signature:__________________________ Date:____________________
 FOR OFFICE USE ONLY

INTERVIEW RATING
FACTORS EXCELLENT GOOD FAIR POOR
Appearance Hire
Fluency of speech
Working Experience
Job Knowledge KIV
Education
Potential
Reject
General Knowledge &
Interests
Additional Remarks

Interviewer 1: Interviewer 2: Interviewer 3:

____________ ____________ ____________

Signature Signature Signature
Date Date Date

FINAL DECISION
Employing Company: Department: Job Title:

Job Grade:

Expected Join Date: Probation Period: Starting Salary:

Remarks: Confirmation Salary:

Recommended by: Approved by:

Signature: Signature:

Date: Date: