EMPLOYMENT APPLICATION FORM
Position Applied : Interior Design Intern
(Photo)
EMPLOYEE INFORMATION
I. PERSONAL INFORMATION
1. Name : Fifi Rahimayanti
2. Sex : Female
3. Home Address : Pondok Ungu Permai blok E 18 No 24 Rt 005 Rw 014. Bekasi Utara 17125
4. Phone Number : 08587497642
5. Place & Date of Birth : Bekasi 07 October 1995
6. Religion : Islam
7. Nationality : Indonesia
8. Ethnicity :-
9. Email Address : [email protected]
10.ID/KTP Number :
II. FAMILY BACKGROUND
1. Marital Status :
Single
Married Year :
Divorced Year :
2. Family Structure
FAMILY NAME SEX AGE LAST EDUCATION OCCUPATION
Father Zainal
Mother Afnita
Brother / 1
Sister
2
3
4
Stepbrother 1
/Sister
2
Spouse
Children 1
2
3
4
III. EDUCATION AND SKILLS
1. Formal
SCHOOLS / INSTITUTIONS
SUBJECT LOCATION MAJORING START FINISH GPA
NAME
1. SENIOR HIGH
SCHOOL
2. ASSOCIATE
(DIPLOMA) I / II / III
3. BACHELOR (S1) Universitas Tarumanagara Jakarta Barat 2014
4. MASTER (S2)
5. DOCTORAL (S3)
2. Informal Education / Training / Course / Seminar
SUBJECT / TOPIC YEAR DURATION PROVIDER SERTIFICATION
3. Skills
LANGUAGE COMPUTER
LANGUAGE ACTIVE/PASSIVE PROGRAM/SOFTWARE POOR/FAIR/GOOD
4. Achievements
CERTIFICATION
ACHIEVEMENT YEAR INSTITUTION
(YES/NO)
IV. ACTIVITIES
1. Organization Activities
ORGANIZATION POSITION YEAR MAIN DUTY
2. Job Experiences
YEAR COMPANY NAME JOB TITLE LAST SALARY
JOIN LEAVE
JOB DESCRIPTION :
REASON FOR LEAVING :
YEAR COMPANY NAME JOB TITLE LAST SALARY
JOIN LEAVE
JOB DESCRIPTION :
REASON FOR LEAVING :
YEAR COMPANY NAME JOB TITLE LAST SALARY
JOIN LEAVE
JOB DESCRIPTION :
REASON FOR LEAVING :
3. INTERESTS (tick your answer)
Working in the office
Reason :
Mobile
Reason :
Working with people
Reason :
Working together in a group
Reason :
Working individually
Reason : ..
4. Please indicate the division and position you are interested in :
Administration
Marketing
Human Resources
Finance/Accounting/Tax
Information Technology
Business Development
Sales
Etc (please specify) ...............................
5. Hobbies
HOBBIES
a. Are you willing to be relocated anywhere in our branches? If no, please explain.
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b. Please mention the salary expectation.
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c. Do you have relatives and/or friends who worked in Kolega Coworking Space? If yes, please
mention the name(s) and relationship(s).
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V. OTHERS
1. Weight : 40 Kg
2. Height : 150 Cm
3. Have you ever had serious illness or undergone surgerry or gotten into serious accident? If yes, please
explain.
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4. Do you have any serious illness that require specific condition for working? If yes, please explain.
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5. Have you ever take psychological evaluation? If yes, please mention the time, place, and aim.
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6. In your opinion, what are your strength and weakness? Please mention 3 for each.
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Herewith I would like to declare that all data I have informed above are true. If this process will continue, I
agree to give other data/information as need for selection process at Kolega Coworking Space.
Date :
Applicant Signature,
