HRD Division

CARITA GROUP

FORMULIR APLIKASI
(RAHASIA)

A. Data Pribadi

Nama : _______________________________________________

Tempat/tgl. Lahir : ____________________________ Usia _____________

Alamat : _______________________________________________

Kode Pos _____________ Telp ___________________

e-mail ___________________ HP __________________

No. KTP/Pasport : ______________________ berlaku s/d _____________

No. Rekening : _________________________ Bank ________________

Atas nama _________________ Cabang _____________

Warganegara : ________________________________________

Status : ________________________________________

Agama : ________________________________________

Anak ke : ________________________________________

Nama orang tua : ________________________________________

Saudara yang bekerja : 1) _____________________________________

Perusahaan ___________________ bag. ___________________

2) _____________________________________

Perusahaan ___________________ bag. ___________________

3) _____________________________________

Perusahaan ___________________ bag. ___________________

Tinggal bersama : Orang tua / kost / rumah sendiri / _________________

Kode Pos ______________ Telp. ___________________

Nama suami/istri : ________________________________________

Alamat : ________________________________________

Kode Pos ______________ Telp. ___________________

 HRD Division
CARITA GROUP

Nama anak : 1) __________________________ Usia : _____________

2) __________________________ Usia : _____________

3) __________________________ Usia : _____________

Tanggungan lainnya : ________________________________________

Kesehatan : baik / sedang / buruk / ___________________

Daya tahan tubuh : baik / sedang / buruk / ___________________

Pernah sakit berat : □ Ya, sakit ______________________________

Tahun ____________ selama ____________

□ Tidak

B. Latar Belakang Pendidikan

Pendidikan Formal

SMA / STM / SMEA _____________________ di _______________ th _______ s/d _______

Diploma _____________________ di _______________ th _______ s/d _______

Universitas-S1 _____________________ fakultas _______________ Jurusan ______________

di _____________________ th ________ s/d _______

Universitas-S2 _____________________ fakultas _______________ Jurusan ______________

di _____________________ th ________ s/d _______

Pendidikan Informal

_________________________________ di _____________________ th _______ s/d _______

_________________________________ di _____________________ th _______ s/d _______

_________________________________ di _____________________ th _______ s/d _______

_________________________________ di _____________________ th _______ s/d _______

Pengetahuan / keahlian lain : _______________________________________________

Hobi : _______________________________________________

Kegiatan waktu luang : _______________________________________________

Organisasi / Aktivitas sosial : _______________________________________________

Pernahkah anda meraih beasiswa? Ya / Tidak, Kapan? _______________________________

 HRD Division
CARITA GROUP

Keahlian Komputer yang dikuasai :

Program / Software ________________________________________ B C K

________________________________________ B C K

________________________________________ B C K

________________________________________ B C K

________________________________________ B C K

Bahasa asing yang dikuasai ___________________________ (Aktif: B C K, Pasif: B C K)

___________________________ (Aktif: B C K, Pasif: B C K)

___________________________ (Aktif: B C K, Pasif: B C K)

Ket: B = baik, C = cukup, K = kurang

C. Pengalaman Kerja

1) Perusahaan ___________________________________________________________

Posisi/Jabatan ________________________ bl/th _____________ s/d _____________

Divisi / Dept _______________________ Nama Kep. Divisi/Dept. _______________

2) Perusahaan ___________________________________________________________

Posisi/Jabatan ________________________ bl/th _____________ s/d _____________

Divisi / Dept _______________________ Nama Kep. Divisi/Dept. _______________

3) Perusahaan ___________________________________________________________

Posisi/Jabatan ________________________ bl/th _____________ s/d _____________

Divisi / Dept _______________________ Nama Kep. Divisi/Dept. _______________

4) Perusahaan ___________________________________________________________

Posisi/Jabatan ________________________ bl/th _____________ s/d _____________

Divisi / Dept _______________________ Nama Kep. Divisi/Dept. _______________

5) Perusahaan ___________________________________________________________

Posisi/Jabatan ________________________ bl/th _____________ s/d _____________

Divisi / Dept _______________________ Nama Kep. Divisi/Dept. _______________

 HRD Division
CARITA GROUP

Nomor NPWP : ____________________________ No. Astek ____________________

Alasan anda memilih bekerja di perusahaan kami : __________________________________

_________________________b
_____________________________________________________

Posisi yang diminati : ____________________________ Alasannya : ____________________

______________________________________________________________________________

Sanggupkah Anda bekerja lembur? : __________________________________

Bersediakah Anda dinas di luar kota? : __________________________________

Bersediakah Anda dimutasi ke luar kota? : __________________________________

Gaji terakhir : Rp. __________________________

Fasilitas terakhir : __________________________________________________________

Gaji yang diminta : Rp. __________________________

Fasilitas yang diminta : □ Pengobatan sesuai peraturan perusahaan

□ Cuti tahunan

□ ___________________________________________________

□ ___________________________________________________

Mulai dapat bekerja : _____________________________________________________

D. Personality

Motto Hidup Saya : ………………………………………………………………………………………………………….

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Yang saya sukai dari diri saya :
- Fisik : ………………………………………………………………………………………………………....
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- Sikap / Sifat : ………………………………………………………………………………………………………....
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 HRD Division
CARITA GROUP

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Pengalaman yang paling menyenangkan selama hidup :
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Pengalaman yang paling pahit selama hidup :
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Kelebihan diri saya :
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Kelemahan diri saya :
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Usaha / cara saya untuk memperbaiki kelemahan :
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Kemampuan (skill) yang saya miliki untuk self development :
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 HRD Division
CARITA GROUP

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Motivasi saya bekerja di HARITA Group :
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Yang akan saya lakukan di HARITA Group jika saya diterima sebagai karyawan :
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Demikian biodata ini saya buat dengan sebenar-benarnya.

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Yang menyatakan,

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