PRIVATE & CONFIDENTIAL

IDENTITAS

No Peserta

Nama

: _____________________________________________

Tempat / Tgl. Lahir

: _____________________________________________

Agama

: _____________________________________________

Status Keluarga

: _____________________________________________

Hobby

: _____________________________________________

Psikolog :

: _____________________________________________
Alamat Kontak

: HP __________________________________________
e mail _______________________________________

PENDIDIKAN
-

SMA ________________________________ DIKOTA ____________________________________

JURUSAN ___________________________ LULUS TAHUN _______________________________

D 1/2/3 ___________________ UNIV _______________________ DI KOTA ___________________

JURUSAN ___________________________ LULUS TAHUN _______________________________

S1 _______________________ UNIV _______________________ DI KOTA __________________

JURUSAN ___________________________ LULUS TAHUN _______________________________

S2 _______________________ UNIV _______________________ DI KOTA __________________

JURUSAN ___________________________ LULUS TAHUN _______________________________

S3 _______________________ UNIV _______________________ DI KOTA __________________

JURUSAN ___________________________ LULUS TAHUN _______________________________

PENDIDIKAN INFORMAL / PELATIHAN / KURSUS

MODUL

TAHUN

LAMANYA

PENYELENGGARA

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RIWAYAT PEKERJAAN
No.

Periode tahun

Nama Perusaan

Jabatan

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PRIVATE & CONFIDENTIAL

PERTANYAAN BERIKUT INI, KHUSUS UNTUK PEKERJAAN YANG TERAKHIR ATAU PILIHAN 1
RIWAYAT PEKERJAAN ANDA YANG MENURUT ANDA PALING BERKESAN :
1. GAMBARKAN STRUKTUR ORGANISASI DI PERUSAHAAN DI MANA ANDA BERADA DAN
TUNJUKKAN DIMANA ANDA BERADA :

2. Uraikan tugas tugas pokok anda :

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3. Jelaskanlah tugas tugas tambahan yang lain bila ada :
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4. Apakah yang anda rasakan paling menarik dalam memikul tanggung jawab jabatan saat ini ?
( Mohon jelaskan secara rinci )
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5. Apakah yang anda rasakan kurang sukai dalam memikul tanggung jawab jabatan saat ini ?
( Mohon jelaskan secara rinci )
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PRIVATE & CONFIDENTIAL

6. Sebutkan faktor faktor penting ( 4 atau 5 faktor ) yang mempengaruhi keberhasilan dalam pelaksanaan tugas pokok anda ( Mohon jelaskan secara rinci )
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7. Uraikan pengalaman nyata yang merupakan keberhasilan anda dalam menjalankan tugas
( berikan 3 atau 4 contoh )
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8. Apa pengalaman yang kurang menyenangkan atau kurang berhasil yang pernah anda alami dalam
Menjalankan tugas ? ( berikan 2 atau 3 contoh kejadian )
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9. Menurut anda faktor apakah yang menyebabkan terjadinya pengalaman tersebut diatas
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PRIVATE & CONFIDENTIAL

MINAT DAN HARAPAN

1. Apakah pekerjaan yang anda lakukan saat ini sudah sesuai dengan pendidikan dan minat anda ?
Jelaskan pendapat anda !
Sesuai
Kurang sesuai
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2. Apabila ada kesempatan, apakah anda ingin melakukan / mencoba bidang pekerjaan lain ?
Ingin

Belum siap

Uraikan aspirasi pengembangan karir yang anda harapkan

BIDANG *)

POSISI YANG DI HARAPKAN

ALASAN SINGKAT

*) bidang pekerjaan / industri

3.

Menurut pendapat anda, apa yang harus dilakukan untuk menunjang pengembangan karir anda
tersebut diatas ( baik oleh perusahaan maupun oleh anda sendiri ? )
OLEH PERUSAHAAN

OLEH DIRI PRIBADI

4. Bila ada harapan harapan lain, silahkan anda kemukakan disini

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LAIN LAIN
1.

Apakah yang menjadi kekuatan ( strong point ) anda ?

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2. Aspek apakah yang ingin anda perbaiki pada diri anda ?

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