POST APPLIED FOR : SENIOR SALES MANAGER
INSTRUCTIONS
1) The app;ication form must be completed in accordance with the instructions on this form. Failure to comply with the instructions
may seriounsly effect consideration of the applocation. False particulars or willful suppression of material facts will render you liable
to disqualification or - if appointed - to dismiscal and/or appropriate legal procedinge,
2) A copy each of your birth certificate, naturalisation or eitizenship certificate, educational certificate and testimonials must accompany
the application. All attedmate to your appplication must bear your name.
A. PARTICULARS OF INFORMATIONS
NAME : MR/MISS/MRS/MDM MUCHAMAD FANDI
ADDRESS : JALAN WARGA NO. 60 PONDOK RANGGON, CIPAYUNG, JAKARTA TIMUR Tel No :
Birth Date : 24-Feb-80 Birth Place : JAKARTA Race : JAWA Dialects : JAKARTA
KTP/PASSPORT: 31750420402800007 SIM AS IF ANY: 1205-8002-000130 Citizenship : WNI Age : 44
Sex : MALE Religion : ISLAM Income Tax No :
Marital Status : Single Married Separated Divorced Widowed
If Married, State Spouse Name : LATHIFAH BARKAH Occupation
No of Children : 3 Age Range :
In Case of Emergency, to Notify Name LATHIFAH BARKAH Relationship : WIFE
Address : IDEM Tel No
Are you Serving Bond with your Present Employer ? Yes No
B. SALARY
Present Salary per month :
Basic : 25 mio Gross :
Expected salary per month :
Basic : 30 mio Gross :
C. DATE OF EMPLOYMENT
1. How soon after being offered appointment can you commence employment ? 2 weeks
2. Would you be prepared to be located in indonesia Yes No
3. Driving License you possess/pass Yes No
D. EDUCATION
LEVEL NAME OF SCHOOL ADDRESS FROM TO DID YOU GRADUATE DETAILS
Primary SD 09 NEGERI JAKARTA
Secondary SMPN 20 JAKARTA
High
SMUN 81 JAKARTA
College
IPB BOGOR 1998 1999
University
UNIVERSITY OF INDONESIA DEPOK 1999 2005
Other
If you Plant Further Education Please Explain :
Any Licensed in Profession of Award From Job.
Trade State Kind and Where Registered :
Hobbies : TRAVEL
,
E. TERTIARY QUALIFICATIONS YEAR
Degree :
Class of Honours
Major Subjects :
Name of University/Institution :
F. OTHER QUALIFICATIONS/COURSES ATTENDED
State date obtained/yet to be obtained
G. EMPLOYMENT HISTORY (in chronological order)
Date Mth/Yr Posts held including Salary
From To Present post Start Ending Name & Address of Company Reason for Leaving
2006 2010 Technical Sales Engineer 4.5 mio 7.5 mio PT Duta Polykem Indo
2010 2011 Sales Manager 10 mio 10 mio PT Rabana Chemical
2011 2013 Sales Manager 11.5 mio 11.5 mio PT Pasadena Ventures Indonesia
2013 2017 Project Coordinator 13 mio 17.5 mio PT Kubic Energy
2017 2018 Business Development Mgr 17 mio 17 mio PT Vtech Mulia
2018 current Asessor PT LSP UMKM
2019 2020 SMBD Asisstant Mgr 14 mio 14 mio PT IEV Gas
2020 current Business Development Head 14 mio 25 mio PT Tangguh Beningmas Pratama
Note : Will you give permission for us to contract your previous emplover or current or current emplover
H. LANGUAGES DIALECT
State your level of proficiency in each language, eg elemantary or advenced
.
Written and Spoken : ENGLISH
Shoken only :
I. CHARACTER REFREES
Name two persons Name Address Occupation Years Known
(other than relatives)
Who know you well
J. MEDICAL HISTORY
1 Have you been or are you suffering from any physical impairment, disease or mental illness ? NO
2 Have you ever been convicted in a Court of law in any country ? NO
K. DECLARATION
I I hereby declare that all the particulars in this application
and the attached sheets are true to the to the best of my knowledge and belief and I have not willfully suppressed any material fact.
Date …… 22-Oct-24 Signature of Applicant ……………… muchamad fandi
" Specialists in the water & waste water treatment "
