Human Resource Department

PT. Global Informasi Bermutu

Jl. H. R Rasuna Said Blok X-2 Kav 5 Jakarta 12950 Telp (021) 5292 1115. Fax (021) 5292 1771

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FORMULIR LAMARAN KERJA

APPLICATION FOR EMPLOYMENT
PRIVATE
DATA PRIBADI/ PERSONAL DATA
NAMA
NAME

TEMPAT TANGGAL LAHIR

JENIS KELAMIN

Laki-laki

Perempuan

PLACE & DATE OF BIRTH

GENDER

Male

Female

NOMOR KTP

GOLONGAN DARAH

ID NUMBER

BLOOD TYPE

AB

KEWARGANEGARAAN

INDONESIA

LAINNYA

CITIZENSHIP

OTHERS

AGAMA

ISLAM

KATOLIK

PROTESTAN

BUDHA

HINDU

LAINNYA

RELIGION

MOSLEM

CATHOLIC

PROTESTANT

BUDHA

HINDU

OTHERS ________________________

ALAMAT RUMAH

KODE POS

HOME ADDRESS

POSTAL CODE

TELEPON RUMAH

TELPON GENGGAM

HOME PHONE

MOBILE PHONE

EMAIL

SEBUTKAN JABATAN YANG ANDA INGINKAN

INDICIATE POSITION APPLIED FOR

DATA KELUARGA / FAMILY DATA

STAUS PENIKAHAN

LAJANG

JANDA/DUDA

MARITAL STATUS

SINGLE

DIVORCED

MENIKAH, TAHUN _____________________

MARRIED, YEAR

SUSUNAN ANGGOTA KELUARGA

FAMILY

NAMA

L/P

USIA

PENDIDIKAN

PEKERJAAN

NAME

M/F

AGE

EDUCATION

WORK

SUAMI/ISTRI
SPOUSE

ANAK 1
1 st child

ANAK 2
2 nd CHILD

ANAK 3
3 rd CHILD

INFORMASI KELUARGA ANDA

PARENT'S INFORMATION

AYAH
FATHER

IBU
MOTHER

SAUDARA KANDUNG

PENDIDKAN FORMAL /FORMAL EDUCATION (ATTACH FOTOCOPY AND DETAILS)

TAHUN
JENJENG LEVEL

NAMA LEMBAGA PENDIDIKAN

JURUSAN

GPA

LEVEL

NAME OF INSTITUATION

MAJOR

QUALIFICATION ATTAINED

YEAR

MASUK

LULUS

ENTRY

GRADUATE

SLTA
HIGH SCHOOL

UNIVERSITAS/ACADEMY
UNIVERSITY/ACADEMY

PASCA SARJANA
POSTGRADUATE

SEBUTKAN ANGGOTA ,ASOSIASI ATAU CLUB YANG DIIKUTI,

PLEASE INDICATE IF YOU ARE MEMBER OF ANY PROFFESIONAL ASSOCIATION, SOCIETY OR CLUB

SEBUTKAN AWARD YANG PERNAH DI TERIMA

PLEASE LIST ANY AWARD ATTAINED

PENDIDIKAN NON FORMAL /FORMAL EDUCATION

JENIS KURSUS / TRAINING

TAHUN

LAMA

IJAZAH

DIBIAYAI OLEH

COURSE / TRAINING

YEAR

DURATION

CERTIFICATE

SPONSORED BY

KEMAMPUAN BAHASA ASING/LANGUAGE PROFICIENCY

BAHASA
LANGUAGE

TERTULIS

LISAN

WRITE

SPEAK

BACA
READ

BAIK

CUKUP

KURANG

BAIK

CUKUP

KURANG

BAIK

CUKUP

KURANG

FLUENT

FAIR

SLIGHT

FLUENT

FAIR

SLIGHT

FLUENT

FAIR

SLIGHT

PENGUASAAN KOMPUTER / COMPUTER PROFECIENCY

TINGKAT PENGUASAAN
NO.

LEVEL OF PROFICIENCY

JENIS PROGRAM/APLIKASI
PROGRAM APPLICATION

BAIK

CUKUP

KURANG

GOOD

FAIR

SLIGHT

KEGIATAN EKSTRA KURIKULER/CO-CURRICULAIR ACTIVITIES (CCA)

PENDIDIKAN

EKSTRA KURIKULER

POSISI

EDUCATION LEVEL

CCA

POSITION HELD

SAAT INI
CURRENT

UNIVERSITAS
UNIVERSITY
2

PENGALAMAN KERJA / EMPLOYMENT HISTORY

PLEASE PROVIDE DETAILED EMPLOYMENT HISTORY. START WITH YOUR CURRENT/LATEST EMPLOYMENT

NAMA PERUSAHAAN ,ALAMAT TERMASUK TELEPONE DAN EMAIL

NAME, ADDRESS OF EMPLOYER INCLUDING TELEPHONE AND EMAIL

BIDANG USAHA
LINE OF BUSINESS

DARI (BLN/THN)

SAMPAI MM/YY

FROM (MM/YY)

UNTIL MM/YY

JABATAN

GAJI TERAKHIR

POSITION HELD

LAST DRAWN SALARY

TUNJANGAN
OTHER ALLOWANCE

BONUS
GUARANTED BONUS

INSENTIF
VARIABLE BONUS,IF ANY

BENEFIT YANG DI TERIMA

BENEFIT

TUGAS DAN TANGGUNG JAWAB

DESCRIBE YOUR DUTIES AND RESPONBILITIES

ALASAN UNTUK MENGUNDURKAN DIRI

REASON FOR LEAVING

NAMA PERUSAHAAN ,ALAMAT TERMASUK TELEPONE DAN EMAIL

NAME, ADDRESS OF EMPLOYER INCLUDING TELEPHONE AND EMAIL

BIDANG USAHA
LINE OF BUSINESS

DARI (BLN/THN)

SAMPAI MM/YY

FROM (MM/YY)

UNTIL MM/YY

JABATAN

GAJI TERAKHIR

POSITION HELD

LAST DRAWN SALARY

TUNJANGAN
OTHER ALLOWANCE

BONUS
GUARANTED BONUS

INSENTIF
VARIABLE BONUS,IF ANY

BENEFIT YANG DI TERIMA

BENEFIT

TUGAS DAN TANGGUNG JAWAB

DESCRIBE YOUR DUTIES AND RESPONBILITIES

ALASAN UNTUK MENGUNDURKAN DIRI

REASON FOR LEAVING

KEGIATAN LAINNYA / OTHER ACTIVITIES

NAMA ORGANISASI

JENIS ORGANISASI

TAHUN

JABATAN

ORGANIZATION NAME

TYPE OF ORGANIZATION

YEAR

POSITION

PENGALAMAN MEMIMPIN
LEADERSHIP EXPERIENCE

MINAT DAN KONSEP PRIBADI / PERSONAL INTEREST AND CONCEPT

DARIMANA ANDA MENGETAHUI ADANYA LOWONGAN INI ?
WHERE DID YOU HEAR THIS POSITION?

BERIKAN NOMOR SECARA BERURUTAN UNTUK JENIS PEKERJAAN YANG ANDA SENANGI
INDICATE YOUR JOB INTEREST IN THE RANK ORDER

SALES

MARKETING

CUSTOMER SERVICE

CALL CENTER

PUBLIC RELATIONS

LEGAL

PURCHASING

INFORMATION TECHNOLOGY

TECHNIC

FINANCE

HUMAN RESOURCE

GENERAL SERVICE

QUALITY ASSURANCE

SECRETARY

LAINNYA

MENGAPA ANDA MEMILIH 2 (DUA) NOMOR PERAMA TERSEBUT ?

WHY DID YOU CHOOSE THE FIRST TWO JOBS?

BERAPA GAJI YANG ANDA INGINKAN ?

HOW MUCH SALARY DO YOU EXPECT?

FASILITAS APA SAJAKAH YANG ANDA INGINKAN SELAIN GAJI ?

WHAT OTHER FACILITIES /ALLOWANCE DO YOU EXPECT ?

KAPAN ANDA DAPAT MULAI BEKERJA ?

WHEN WILL YOU BE TO START TO WORK?

KETERANGAN LAINNYA / OTHER INFORMATIONS

BERAT BADAN

TINGGI BADAN
_____________ KG
HEIGHT
APAKAH ANDA PERNAH DIRAWAT DI RUMAH SAKIT DAN ATAU MENDERITA SAKIT YANG LAMA ?

WEIGHT

_____________ CM
YA
YES

HAVE YOU BEEN HOSPITALIZED AND / OR SERIOUSLY ILL FOR A LONG TIME ?

TIDAK
NO

APAKAH ANDA PERNAH MENGIKUTI EVALUASI PSIKOLOGIS ?

YA

TIDAK

HAVE YOU EVER TAKEN A PSYCHOLOGICAL TEST ?

YES

NO

SEBUTKAN NAMA KENALAN ANDA DI PERUSAHAAN KAMI

NAME YOUR FRIENDS / RELATIVES IN PT. GLOBAL INFORMASI BERMUTU

REFERENSI DAN REKOMENDASI / REFERENCE AND RECOMMENDATION

REFRENSI DAN REKOMENDASI TENTANG ANDA DAPAT DI PEROLEH DARI :
FURTHER REFERENCE AND RECOMMENDATION ABOUT THE CANDIDATE CAN BE OBTAINED FROM :

NAMA

ALAMAT DAN NOMOR TELEPON

JABATAN

HUBUNGAN

NAME

ADDRESS AND PHONE NUMBER

POSITION

RELATION

DECLARATION
I authorize background investigasion of all stalments contained in this record if I am considered for employment. I understand that a
misinterpretation or mission fact called for herein suffcient cause for cancellation of consideration of employment or dismissal from the company
service if I have been employment. I understand that employment is subject to satisfactory background investigation check, including verification of
my employment status with my present employer and a medical examination in which my health must be found to be satisfactory to the company. I
acknowledge that all above information and statement may be transferred to, accesses and/or utilized by other entities now or here after within
GlobalTV of companies for consideration of my application or placement.

TANDA TANGAN PELAMAR

TANGGAL

APPLICANT

DATE