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Vo lunte er Appl ic ation Fo rm

A. PERSONAL DATA
1. GENERAL INFORMATION
First Name: Au li a _ Last Name: Agu s t in
Date of Birth: Au gu s t 1 8 t h , 1 9 9 1 _ Occupation: n gl is h ! u t o r " # n $ er gr a $u at e % t u $ en t
&iti'enship: ( n $o n es ia )assport No:
A$$ress: * al an + e m an g , ! - - 9 , . - 1 1 N o / 0 1 , + ali s ar i , ) as ar , e2 o , * a 3 ar t a ! im u r
&it4: * a3 ar t a _ )ostal &o$e 1 1 5 9 - _ &ountr4: ( n $ o n e s i a
)hone Num2er6 7ome: 89 0 0 1 8 5 0 5 0 1 - _ .or3: _ Fa::

;o2ile: 89 0 8 9 9 < 0 = 5 = < = 8 mail: au li a/a gu s t in > s am po er n ae $u c at io n /n et
,eligious A?iliation @optionalA (s lam
2. SPECIALIST
nglish Language !eaching
7an$icrafting @&rochet %tichesA
&hoir %inger @%opranoA
;oBie ;a3ing @.in$oCs ;oBie ;a3erA
(n$onesian !ra$itional Dancing @%irih +uning $anceA
Drama @liste$ as the 2est $rama actress in Drama FestiBal in %%A
3. LIST OF QUALIFICATION (S) OBTAINED
Qualificai!"# $%a& O'ai"%( I"#iui!"
%enior 7igh %chool 0--9 %;AN 19 *a3arta
7igher (nterme$iate nglish 0--9 Lem2aga (n$onesia D Ameri3a
Di?erentiate$ (nstruction 0-11 %ampoerna %chool of
$ucation
(nternational Facilitator an$
(nterpreter
0--9Drecent $ucational &onference
Volunteer for marginal chil$ren 0-11 *am2ore %aha2at Ana3
B. )OLUNTEERING DETAIL
*. +!, (i( -!u l%a&" a'!u .% Ca/illia" S!cial C%"%& C.ia"0&ai1
( foun$ the Ce2site from a search engine @EoogleA, then ( learne$ an$ sprea$ this
information to m4 colleagues
2. R%a#!" f!& 3!lu"%%&i"01
( am an nglish Language !eacher can$i$ate, 2ut ( am reall4 intereste$ to 3noC more
a2out the special nee$ e$ucation/ ( get in touch Cith chil$ren intensiBel4 since ( am also an
nglish tutor for primar4 school stu$ents/ Later on Chen ( finish college, an$ ( Cill Cor3
professionall4 as an nglish teacher, thus ( ma4 fin$ $isa2le$ chil$ren cases in m4 class/
For that, ( reall4 nee$ to prepare m4self for these cases ( Coul$ face in the real situation/ (
am Cilling to learn from this 3in$ of Bolunteerism/ Besi$es that, ( loBe chil$ren an$ ( li3e to
help them Cith m4 oCn Ca4/
4. Pl%a#% &%c!"fi&/ -!u& a&%a !f i"%&%# a"( al%".
;4 passion is to teach nglish to other people/ ;oreoBer, ( am reall4 intereste$ in
teaching nglish to chil$ren Cith special nee$ cases/ ( li3e also to help others learn
arts, such as: singing, (n$onesian tra$itional $ancing, an$ role pla4ing/ ;4 s3ills an$
talent Coul$ 2e Ber4 2eneficial for people out there/
5. Pl%a#% fill .% 6%&i!( !f -!u& 3!lu"%%& a3aila'ili-7
%tart $ate: @$$"mm"44A -1 " - 9 " 0 - 1 0 n$ $ate: @$$"mm"44A -1 "1- "0 - 1 0
8. Pl%a#% 6&!3i(% ,! &%f%&%"c%# .a ,% c!"ac (%9clu(i"0 &%lai3%# a"(
&!!//a%#)
,.! .a3% :"!," -!u f!& /!&% .a" ,! -%a&#.
1/ Name: Arlin )usparini _ ,elationship: &olleague
A$$ress: * alan !aman &ipinang no/ 01 ,! --0 ,. -9, *atinegara/ _
&it4: * a3 ar t a )ostal &o$e: 1 1 =0- &ountr4 ( n $ o n e s i a
)hone Num2er6 7ome: .or3: Fa::
;o2ile: 8 9 0 8<99=559<-9 _ mail: arlin/pusparini>sampoernae$ucation/net _
0/ Name: Nurul Fitri 7a$4ani _ ,elationship: &olleague
A$$ress: * alan +p/ ,a$en ,! --9 ,. --5 No/ =1, )e3a4on, )asar ,e2o/ _
&it4: * a3a rta )ostal &o$e: 115 1- &ountr4 ( n $ o n es i a _
)hone Num2er6 7ome: .or3: Fa::
;o2ile: 8 90 8<9915-5-11 _ mail: nurul/ha$4ani>sampoernae$ucation/net _
;. +a3% -!u %3%& '%%" c!"3ic%(< 6l%a( "! c!"%# !& 6l%a( =uil- ! a f%l!"- !&
/i#(%/%a"!&1
Fes _ No G
Ca/illia" S!cial C%"%& C.ia"0&ai &%#%&3%# .% &i0. ! &%=u%# 6!lic% cl%a&a"c%
c%&ifica%.
Si0"au&%7 _
Da%7 ; a 4 8 t h , 0 - 1 0
>>> Pl%a#% aac. a 2.2 9 3 i"c. 6.!!

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