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MULYADI
You want us to address you as:
Home
Telephone:
Office
Telephone:
Date of
birth:
Sex:
KECAMATAN JATINEGARA
Mobile:
JAKARTA TIMUR
Email:
21-04-1977
Male /
Female
Marital
Status
Age:
36
thn
Place
of
Birth:
JAKARTA
No of
Childre
n:
MARRIED
2 (TWO)
ID
Passport No &
3175032104771001
No
Expire Date
Bank Name & Account No (for disbursement of
salary)
NPWP Number 77.457.970.0-002.000
2.
02168859263
Zen2000id@yahoo,com
Nationalit
y:
Race/Ethni
c Group
Religion
INDONESIA
PADANG
ISLAM
S/N
1.
Name
NURCHASIYAH
Age
33
Relationship
WIFE
Occupation
ACCOUNTANT
2.
SON
STUDENT
3.
AURA A.ALYAKEISYAH
SON
STUDENT
4.
H.DARLEN
73
FATHER
UNEMPLOYEE
5.
HJ.MASNIAR
68
MOTHER
HOUSE WIFE
6.
MASWIR
42
BIG BROTHER
SALES
7.
HERIYANTO
38
BIG BROTHER
Electrical contractor
8.
HENNY GUSNITA
32
LITTLE SISTER
HOUSE WIFE
9.
10.
Application for Employment August 2013
Page 1 of 5
3.
QUALIFICATIONS
S/N
Education
Institution Location
Subjects Taken
Years
Grade
1.
UPI-YAI
JAKARTA
ACOUNTING
1994
1999
2.
SMUN 77
JAKARTA
IPS
1991
1994
3.
SMP-MUH III
JAKARTA
1988
1991
4.
5.
6.
7.
8.
4.
SKILLS
Others
5.
Please give us a candid account of your personal qualities, other strengths and weaknesses.
Im an accounting
Ive been working five years as a Finance and Accounting
Ive Excellent analytical skills
Im Able to work independently
6.
State your ECA in school / college / university / community / workplace giving level of participation and
office held.
Organisasi remaja ISLAM
7.
EMPLOYMENT HISTORY
Page 2 of 5
Current
Employer
PT.QMI
From
2009
Previous
Employers
From
To
2013
To
Current
Position
SPV
Position
Present
Salary
Bonus /
AWS /
Benefits
5.000.000
Last Drawn
Salary
Bonus /
AWS /
Benefits
KAP
2006
2008
AUDITOR
2.500.000
INGIN MENAMBAH
PENGALAMAN
PT.MAJU
2004
2006
SPV ACC
1.000.000
INGIN MENAMBAH
PENGALAMAN
Please give details of your duties in your CURRENT and or / LAST organisation (where
applicable) and state any significant contributions you have made)
Initiative
Dependability
Customer Service
Leadership
What was it about my qualifications that most appealed to you for this role?
If I was starting in this position today, what would you advise me to learn first and
Application for Employment August 2013
Page 3 of 5
do first?
What opportunities do you make available for professional development and
training?
Can we refer to your :
a.
Present Employer
Yes
No
b.
Previous Employer
Yes
No
Salary Expected?
ID
R
8.000.000
NEGOTIABLE
Per
month
Reference
Name
1 BUDIYANSAH
CARTIC.co
2
3
4
9
OTHER RELEVANT INFORMATION
.
If yes, please state
class
X
No
Company
Country of
Issues
Do you have any relative who is working in this Company? If yes, please write the name and the position
below:
___________ NO _____________________________________________________________________________________
9
DECLARATIONS
.
Please answer the following questions by deleting "YES" or "NO" in the boxes provided. If
"Yes", give details in the right hand margin.
1. Have you ever been charged or convicted of any Yes No NO
criminal offence by any Court or detained by the
authorities under the provisions of any law in
any country?
(Please give full details even if you were
eventually acquitted)
2. Has any bankruptcy action ever been taken Yes No NO
against you or any Court judgement / order ever
been made against you ordering you to pay a
debt to someone?
3.
Yes
No
NO
4.
Yes
No
NO
ATTENTION APPLICANT: Please review carefully all the information given in your application form
BEFORE SIGNING.
I hereby declare that the information contained in this form is true and correct to the best of my knowledge and
that I have not withheld any relevant particulars. In the event of employment, this declaration shall be part of
my Contract of Service.
I understand that false or misleading information given in my application or interview (s) shall render me liable
for dismissal without notice and without assigning any reason.
2 DESENBER 2013
Date
Application for Employment August 2013
MULYADI
Signature of Applicant
Page 4 of 5
INTERVIEW EVALUATION
Date
Remarks
Result of
Interview
Suitable
Selected
KIV
Not
Date
Remarks
Result of
Interview
Suitable
Selected
KIV
Not
Approved by Manager
Head of Department
HR Manager
APPOINTMENT
Designation
Level
Department
Company
Date of Appointment
Starting Salary
Allowances
Probation
Page 5 of 5