PT.

TECHNIP INDONESIA
Metropolitan Tower 15th Floor, Jl. RA Kartina Kav 14, Cilandak
Jakarta Selatan 12430, Indonesia
T: +6221 8066 9555
APPLICATION FOR EMPLOYMENT
PT. Technip Indonesia is an Equal Opportunity Employer. We do not discriminate on the basis of
race, religion, color, sex, age, or national origin.
Position Applied For: Date of Application:

Title (Please circle) First Name Last Name

Mr./Mrs./Ms.
Current Address: Tel (M):

Post Code: Tel (H):

Permanent Address:
Tel (H):
Post Code:
Place of Birth: Date of Birth: Blood Type: Email:

ID Card Number: Marital Status:

Single Married Divorced

FAMILY PARTICULARS (If married, list spouse & children / If single, list parents, brothers/sisters)
Relationship Name Age Occupation/Education Place of Occupation/Education

Father
Mother

Brother/Sister

Spouse
Children

Do you have any relative employed anywhere by TechnipFMC ? Yes No If Yes, please give details:
Name Relationship Departemen/Position Location

EDUCATION Name of School From To Qualification Obtained

High School

Polytechnic
University

Post-Graduate
TRAINING/COURSE
Type of Training Institution Period Certification [Yes/No]

EMPLOYMENT RECORD (Please begin with the recent employment in chronological order)
From To Name of Company Position Salary Reason for Leaving

Salary Expectation:

SKILLS (List skills acquired, e.g. language, computer, etc.)

Type of Skills Proficiency

English Basic Intermediate Advanced

MS. Office (Words, Excel, Powerpoint, etc.) Basic Intermediate Advanced

Basic Intermediate Advanced

PERSONAL REFERENCES (List three work references of former employers)

Name Job Title Company Address/Phone Number

Do you have any relatives working for government? Yes No If Yes, please give details:
Name Relationship Departemen/Position Location

OTHERS
Do you have any commitments with any other employer that might Yes No
affect your employment with us?
Do you have any objection to be located outside your point of hire? Yes No
Date available for work:

I certify that the statements made on this application are true and correct. I consent to PT. Technip Indonesia’s verification of the information on this application. I
consent to PT. Technip Indonesia contacting any employers or references listed (current employer will not be contacted without applicant’s authorization). I hereby
release employers, schools or persons from all liability in responding to inquiries in connection with my application. Any falsified statements or misrepresentations
will constitute sufficient grounds for dismissal. I understand that my employment at PT Technip Indonesia may be conditioned upon results of other background
checks as appropriate for the position to which I am applying. I understand that no employee of the company has authority to enter into any agreement for
employment for a specified period of time, or to make any agreement contrary to the foregoing except by written agreement signed by an officer of the company.

Signature of the applicant :

Name : Date :