Pas foto 3x4 cm

APPLICATION FORM
FORMULIR APLIKASI
PERSONAL DATA / DATA PRIBADI

Name / Nama :
Home Address / Alamat :

Sex / Jenis Kelamin :

Telp.No. (Office / Kantor) :
(Home / Rumah ) :
(Mobile / HP) :
Date of Birth / Tanggal Lahir :
Marital Status / Status Pernikahan : Nationality / Kebangsaan : Religion / Agama :
Driving License / Surat Ijin Mengemudi :
EDUCATION & PROFESSIONAL QUALIFICATION / PENDIDIKAN &KUALIFIKASI PROFESIONAL :
NAME OF SCHOOL/COLLEGE / Nama Sekolah STATE LEVEL ATTAINED MAJOR
FROM - TO / Dari-sampai
COURSE/SUBJECT /Tingkatan

MEMBERSHIP OF PROFESSIONAL & OTHER SOCIETIES (state dates and position held) / KEANGGOTAAN
PROFESIONAL & MASYARAKAT LAIN ( tanggal negara dan posisi yang dimiliki )

Computer proficient /Keahlian Komputer : Yes / Ya No / Tidak Type / Mengetik :

Program/Languages (Program / Bahasa) :

Position applied for / Posisi Yang Diinginkan :

Are you interested in any other position / Apakah anda tertarik dengan posisi lain :

Current Salary / Gaji Saat ini : Salary expected / Gaji yang diharapkan :
Details of current remuneration package / Rincian dari paket remunerasi saat ini :
Basic / Pokok
…………….
………………

When are you available to work? / Kapan Siap Mulai Kerja ? Notice period /Pemberitahuan berkala :

* For insurance registration purpose *** For religion day attendance purpose
** For Tax calculation purpose
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EMPLOYMENT HISTORY / PENGALAMAN KERJA
(Commence with current or last employment/Dimulai dari pekerjaan yang sekarang atau sebelumnya)

Date of employment / Tanggal Kerja : Date Employment Ended / Tanggal berakhir kerja :
Company / Perusahaan :
Company's Address / Alamat Perusahaan :

State nature of the business / kondisi bisnis :

Position Held / Posisi Saat itu :
Name & designation of immediate supervisor / Nama atas langsung :

Total number of employees in the company / Total Karyawan : Number of staff supervise by you / Jumlah pengawas anda :

Detailed description of duties/responsibilities /Rincian tugas & tanggung jawab :

How did you get employed in this company (Through Advertisement, Recommendation, etc.) /
Bagaimana kau bisa bekerja di perusahaan ini ( Melalui Iklan , Rekomendasi , dll

Reason for leaving / Alasan Keluar :

Last Salary / Gaji terakhir :

Date of employment / Tanggal Kerja : Date Employment Ended / Tanggal berakhir kerja :
Company / Perusahaan :
Company's Address / Alamat Perusahaan :

State nature of the business / kondisi bisnis :

Position Held / Posisi Saat itu :
Name & designation of immediate supervisor / Nama atas langsung :

Total number of employees in the company / Total Karyawan : Number of staff supervise by you / Jumlah pengawas anda :

Detailed description of duties/responsibilities /Rincian tugas & tanggung jawab :

How did you get employed in this company (Through Advertisement, Recommendation, etc.) /
Bagaimana kau bisa bekerja di perusahaan ini ( Melalui Iklan , Rekomendasi , dll

Reason for leaving / Alasan Keluar :

Last Salary / Gaji terakhir :

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EMPLOYMENT HISTORY / PENGALAMAN KERJA
(Commence with current or last employment/Dimulai dari pekerjaan yang sekarang atau sebelumnya)

Date of employment / Tanggal Kerja : Date Employment Ended / Tanggal berakhir kerja :
Company / Perusahaan :
Company's Address / Alamat Perusahaan :

State nature of the business / kondisi bisnis :

Position Held / Posisi Saat itu :
Name & designation of immediate supervisor / Nama atas langsung :

Total number of employees in the company / Total Karyawan : Number of staff supervise by you / Jumlah pengawas anda :

Detailed description of duties/responsibilities /Rincian tugas & tanggung jawab :

How did you get employed in this company (Through Advertisement, Recommendation, etc.) /
Bagaimana kau bisa bekerja di perusahaan ini ( Melalui Iklan , Rekomendasi , dll

Reason for leaving / Alasan Keluar :

Last Salary / Gaji terakhir :

Date of employment / Tanggal Kerja : Date Employment Ended / Tanggal berakhir kerja :
Company / Perusahaan :
Company's Address / Alamat Perusahaan :

State nature of the business / kondisi bisnis :

Position Held / Posisi Saat itu :
Name & designation of immediate supervisor / Nama atas langsung :

Total number of employees in the company / Total Karyawan : Number of staff supervise by you / Jumlah pengawas anda :

Detailed description of duties/responsibilities /Rincian tugas & tanggung jawab :

How did you get employed in this company (Through Advertisement, Recommendation, etc.) /
Bagaimana kau bisa bekerja di perusahaan ini ( Melalui Iklan , Rekomendasi , dll

Reason for leaving / Alasan Keluar :

Last Salary / Gaji terakhir :

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FAMILY DETAILS / DETAIL KELUARGA*
DATE OF
NAME / Nama PHONE NUMBER (In Case of Emergency) /Nomor yang
RELATIONSHIP /Keluarga BIRTH/Tanggal Lahir
dapat dihubungi dalam keadaan darurat

Spouse (wife/husband)
Pasangan (istri/suami)

Children / Anak

* For Insurance Registration Purpose / Untuk Tujuan pendaftaran Asuransi

THE PERSON TO BE CONTACTED IN CASE OF EMERGENCY: orang

yang di hubungi dalam keadaan darurat :

RELATIONSHIP / Hubungan PHONE NUMBER /

NAME / Nama ADDRESS / Alamat
Nomor telephone

PERSONAL DETAILS / Data pribadi

Does your current health status prevent you from performing any position related tasks? Yes/No
Apakah kesehatan anda saat ini mencegah Anda melakukan tugas-tugas posisi terkait ? Ya / Tidak

(Please explain)
(Mohon Jelaskan) :

Do you take illegal substance? Yes / No

Apakah anda mengkonsum zat ilegal ? Ya / Tidak
Have you ever been convicted in a court of law? Yes / No
Apakah anda pernah terjerat kasus hukum? Ya / Tidak
if so, give details Yes / No
Jika benar berikan penjelasan Ya / Tidak

Have you been dismissed or suspended from any position? Yes/ No

if so, give details :

Do you have any interest or involvement in any business in the hotel or restaurant or travel industry?

(Please specify)

LANGUAGES/BAHASA INDONESIA ENGLISH CHINESE

SPOKEN
WRITTEN
ADDITIONAL INFORMATION - Give any additional information which you consider may be of interest to a
prospective employer, if possible state why you believe you are suitable for the position you are applying to.

Page 4/5
EMPLOYMENT REFERENCES / REFERENSI KARYAWAN
From past & present employment From past & present employment

Name : Name:
Position : Position :
Company Name : Company Name :
Company Address : Company Address :

Telp: (Office ) : Telp: (Office ) :

PERSONAL REFERENCES
Give names of person of responsibility who have known you for at least 3 years

Name : Name :
Position : Position :
Company Name : Company Name :
Company Address : Company Address :

Tel: (Office) Tel: (Office/kantor)

Years of Acquintance: Years of Acquintance:

Name of companies with which you have pending applications for employment

(Give dates of applicant )

Have you applied with this office before? (State date)

No

I HEREBY CONFIRM ALL THE ABOVE DETAILS TO BE TRUE AND CORRECT. I AUTHORISE ADONARA HOSPITALITY
DEVELOPMENT TO CARRY OUT REFERENCE CHECK WITH PAST EMPLOYER AND REFEREES IN CONNECTION WITH THIS
APPLICATION.
I UNDERSTAND THAT ANY MISPRESENTATION OR MISSION OF INFORMATION WILL BE SUFFICIENT REASONS FOR
WITHDRAWL OF AN OFFER OR SUBSEQUENT DISMISSAL, IF EMPLOYED.

Date/Tanggal: Signature/Tanda tangan: