APPLICATION FORM

FORMULIR APLIKASI
PERSONAL DATA/DATA PRIBADI
Name/Nama YOSI SAGITA SUKARNA
Home Address/Alamat Jl.Goa Lempeh [BVLGARI] No.6 Banjar Kangin, Pecatu, Kuta Selatan, Badung ~ Bali Indonesia. Zip Code: 80364

Sex/Jenis Kelamin: LAKI-LAKI

Tel.No. (off/kantor) (0361) 8957 555 Fax: (0361) 8957 600
(Res/Rumah)
(HP) 0822 4751 8748 / 0815 2940 9788
Date of Birth/Tanggal Lahir* Place of Birth/Tempat Lahir: sukabumi
Marital Status/Status**:married Nationality/Kebangsaan:INDONES Religion/Agama***:ISLAM
Driving License/SIM: 881213440292
EDUCATION & PROFESSIONAL QUALIFICATION/KUALIFIKASI PENDIDIKAN
FROM - TO NAME OF SCHOOL/COLLEGE NAMA STATE LEVEL ATTAINED MAJOR COURSE/SUBJECT
DARI-SAMPAI SEKOLAH/ PERGURUAN TINGGI BIDANG & LEVEL PENDIDIKAN
2004 - 2007 SMK LODAYA SUKABUMI TECHNOLOGY & INDUSTRY

MEMBERSHIP OF PROFESSIONAL & OTHER SOCIETIES (state dates and position held)
KEANGGOTAAN DALAM ORGANISASI (Detail tanggal dan posisi)
--

Computer proficient/Pengetahuan Komputer Yes/Ya No/Tidak Type/Jenis:Ms.Word & Ms. Excel

Program/Languages (Program/Bahasa): ENGLISH & JAPANESE

Position applied for/Posisi yang dilamar:

Are you interested in any other position: JUNIOR SOUS CHEF TEPPANYAKI
Apakah Anda tertarik dengan posisi yang lain?JUNIOR SOUS CHEF TEPPANYAKI
Current Salary/Gaji sekarang: Rp.9000.000,- Salary expected/Gaji yang diharapkan:Rp.10.000.000,-
Details of current remuneration package/Keterangan paket remunerasi saat ini:
Rp.5000.000,-

When are you available to work? ANY TIME Notice period: 1 month before
Kapan Anda bersedia mulai bekerja? KAPAN SAJA Periode Pemberitahuan: 1 bulan sebelumnya
* For insurance registration purpose (Untuk keperluan pendaftaran asuransi) *** For religion day attendance purpose
** For Tax calculation purpose (Untuk perhitungan pajak) (Untuk menghadiri acara keagamaan)
EMPLOYMENT HISTORY/PENGALAMAN KERJA
(Commence with current or last employment/Dimulai dari pekerjaan yang sekarang atau sebelumnya)

Date of employment/Tanggal mulai bekerja: 09 JUNE 2014 Date Employment Ended/Tanggal berhenti bekerja : PRESENT / MASIH BEKERJA
Company/Perusahaan: HOTEL ANANTARA BALI - ULUWATU RESORT & SPA
Company:s Address/Alamat Perusahaan: JL. PEMUTIH, LABUAN SAIT, ULUWATU BALI 80364, INDONESIA

State nature of the business/Bidang Bisnis: PERHOTELAN (PARIWISATA)

Position Held/Jabatan: DEMI CHEF TEPPANYAKI
Name & designation of immediate supervisor:
Nama dan posisi atasan langsung: SILFAMI LANDY MANAORINSONG / TEPPANYAKI CHEF
Total number of employees in the company: Number of staff supervise by you:
Jumlah karyawan perusahaan -+147 person Jumlah karyawan yang bekerja dibawah Anda: 1 person
Detailed description of duties/responsibilities/Detail Pekerjaan:

TEPPANYAKI COOK, DINING AND ENTERTAINMENT, PREPARATION FOOD INGREDIENTS, HANDLE COOKING CLASS
●Responsible for preparing and
checking Teppanyaki equipment ●correct stock rotation & minimisation of wastage
●Checking for Teppanyaki sauce and
food ingredients
●Ensuring provision
that the standards of ●Assisting other areas of the kitchen when required
hygiene are maintained & improved
were possible

●Training and of Commis Chefs

How did you get employed in this company (Through Advertisement, Recommendation, etc.)
Bagaimana Anda mengetahui pekerjaan ini? (Melalui Iklan, rekomendasi, lain-lain)
application LinkedIn
Reason for leaving/Alasan berhenti: - (MASIH BEKERJA)
Last Salary/Gaji Terakhir: Rp.9000.000,-

Date of employment/Tanggal mulai bekerja: 1 JUNE 2010 Date Employment Ended/Tanggal berhenti bekerja : 6 JUNE 2014
Company/Perusahaan: HOTEL GRAN MELIA JAKARTA
Company:s Address/Alamat Perusahaan: JL. H.R. RASUNA SAID Kav. X-0 KUNINGAN, JAKARTA 12950, INDONESIA

State nature of the business/Jenis Bisnis: PERHOTELAN (PARIWISATA)

Position Held/Jabatan: COMMIS III
Name & designation of immediate supervisor:
Nama dan posisi atasan langsung: FARID INDRAWAN / SOUS CHEF JAPANESE FOOD
Total number of employees in the company: Number of staff supervise by you:
Jumlah karyawan perusahaan -+ 400 person Jumlah karyawan yang bekerja dibawah Anda: 2 person
Detailed description of duties/responsibilities/Detail Pekerjaan:

PREPARATION FOOD INGREDIENTS FOR TEPPANYAKI COOK & JAPANESE FOODS

●Responsible for preparing and
checking Teppanyaki equipment ●correct stock rotation & minimisation of wastage
●Checking for Teppanyaki sauce and
food ingredients
●Ensuring provision
that the standards of ●Assisting other areas of the kitchen when required
hygiene are maintained & improved
were possible

●Training and of Commis Chefs

How did you get employed in this company (Through Advertisement, Recommendation, etc.)
Bagaimana Anda mengetahui pekerjaan ini? (Melalui Iklan, rekomendasi, lain-lain) application LinkedIn

Reason for leaving/Alasan berhenti: self-development and career

Last Salary/Gaji Terakhir: Rp. 5000.000,-
EMPLOYMENT HISTORY/PENGALAMAN KERJA
(Commence with current or last employment/Dimulai dari pekerjaan yang sekarang atau sebelumnya)

Date of employment/Tanggal mulai bekerja: JANUARY 2010 Date Employment Ended/Tanggal berhenti bekerja : JUNE 2010
Company/Perusahaan: TATSUYA JAPANESE TEPPANYAKI REST
Company:s Address/Alamat Perusahaan: CENTRAL PARK, JAKARTA

State nature of the business/Bidang Bisnis: RESTAURANT

Position Held/Jabatan: COMMIS
Name & designation of immediate supervisor: RUDI HARTONO / TEPPANYAKI CHEF
Nama dan posisi atasan langsung:
Total number of employees in the company: 6 staff cook Number of staff supervise by you:
Jumlah karyawan perusahaan Jumlah karyawan yang bekerja dibawah Anda: 2 person
Detailed description of duties/responsibilities/Detail Pekerjaan:

●Responsible for preparing and

●Preparing and checking
checking Teppanyaki for
equipment ●correct stock rotation & minimisation of wastage
Teppanyaki sauce and food ingredients
provision
●Assisting other areas of the kitchen
when required

How did you get employed in this company (Through Advertisement, Recommendation, etc.)
Bagaimana Anda mengetahui pekerjaan ini? (Melalui Iklan, rekomendasi, lain-lain)

Reason for leaving/Alasan berhenti: self-development and career

Last Salary/Gaji Terakhir: Rp. 2.500.000,-

Date of employment/Tanggal mulai bekerja: AUGUST 2007 Date Employment Ended/Tanggal berhenti bekerja : DECEMBER 2009
Company/Perusahaan:KIRISHIMA JAPANESE RESTAURANT
Company:s Address/Alamat Perusahaan: jl.H.R RASUNA SAID kav.X-0 KUNINGAN, JAKARTA

State nature of the business/Bidang Bisnis: RESTAURANT

Position Held/Jabatan: COMMIS
Name & designation of immediate supervisor:
Nama dan posisi atasan langsung: mr. KYOTAKA MATSUI / japanese chef
Total number of employees in the company: Number of staff supervise by you:
Jumlah karyawan perusahaan 47 person Jumlah karyawan yang bekerja dibawah Anda: 3 person
Detailed description of duties/responsibilities/Detail Pekerjaan:

●Assisting in all areas of the kitchen

●Preparing and checking for sauce and ingredients for all japanese food

How did you get employed in this company (Through Advertisement, Recommendation, etc.)
Bagaimana Anda mengetahui pekerjaan ini? (Melalui Iklan, rekomendasi, lain-lain)

Reason for leaving/Alasan berhenti: self-development and career

Last Salary/Gaji Terakhir: Rp. 1.600.000,-
FAMILY DETAILS/DETAIL KELUARGA*
RELATIONSHIP NAME DATE OF BIRTH PHONE NUMBER (In Case of Emergency)
(Hubungan) (Nama) (Tanggal Lahir) (Nomor Telepon - Untuk Keadaan Darurat)

Spouse (Istri/Suami)
SURI TIANI PUTRI 14 OCTOBER 1983 0813 1500 4773 / 0822 3712 5925
HANANIA SAKURA RAFIFA 5 JANUARY 2016
Children/Anak

* For Insurance Registration Purpose/ Untuk keperluan pendaftaran asuransi

THE PERSON TO BE CONTACTED IN CASE OF EMERGENCY:

Orang yang dapat dihubungi dalam keadaan darurat
NAME RELATIONSHIP PHONE NUMBER ADDRESS
(Nama) (Hubungan) (Nomor Telepon) (Alamat)

SURI TIANI PUTRI ISTRI 0813 1500 4773jl. kayu manis VIII RT.010/007 kel.KAYU MANIS, kec. MATRAMAN

PERSONAL DETAILS/DETAIL PRIBADI

Does your current health status prevent you from performing any position related tasks? Yes/Ya No/Tidak
Apakah status kesehatan Anda menghalangi Anda melakukan pekerjaan Anda?
(Please explain/Jelaskan)

Do you take illegal substance? (Apakah Anda menggunakan obat terlarang?) Yes/Ya No/Tidak
Have you ever been convicted in a court of law? Yes/Ya No/Tidak
Apakah Anda pernah terlibat dalam kasus hukum?
if so, give details/ Jika ya, jelaskan:

Have you been dismissed or suspended from any position? Yes/Ya No/Tidak
Apakah Anda pernah diberhentikan atau diskors?
if so, give details/ Jika ya, jelaskan:

Do you have any interest or involvement in any business in the hotel or restaurant or travel industry?
Apakah Anda memiliki minat untuk atau terlibat di dalam mengelola bisnis hotel, restoran atau industri perjalanan?
(Please specify/Jelaskan secara spesifik)
tidak untuk saat ini
LANGUAGES/BAHASA INDONESIA ENGLISH/INGGRIS CHINESE/CINA ……………. ……………
SPOKEN/LISAN
WRITTEN/TERTULIS
ADDITIONAL INFORMATION - Give any additional information which you consider may be of interest to a
prospective employer, if possible state why you believe you are suitable for the position you are applying to.
INFORMASI TAMBAHAN - Berikan informasi tambahan yang menurut pertimbangan Anda penting bagi perusahaan,
Jika mungkin jelaskan mengapa Anda yakin Anda memenuhi kualifikasi posisi yang Anda lamar.

untuk pengembangan karir dan pengembangan diri

EMPLOYMENT REFERENCES/REFERENSI KARYAWAN
From past & present employment From past & present employment
Pekerjaan yang sebelumnya dan sekarang Pekerjaan yang sebelumnya dan sekarang
Name/Nama: Name/Nama:
Position/Posisi: Position/Posisi:
Company Name/Nama Perusahaan: Company Name/Nama Perusahaan:
Company Address/Alamat Perusahaan: Company Address/Alamat Perusahaan:

Tel: (Office/kantor) Tel: (Office/kantor)

PERSONAL REFERENCES/REFERENSI PRIBADI

Give names of person of responsibility who have known you for at least 3 years
Berikan nama orang yang mengenal Anda minimal selama 3 tahun.
Name/Nama: mr.TOMOAKI ITO Name/Nama: mr.SILFAMI LANDY MANAORINSONG
Position/Posisi: JAPANESE CHEF Position/Posisi: TEPPANYAKI CHEF
Company Name/Nama Perusahaan: YOSHI IZAKAYA REST Company Name/Nama Perusahaan: SONO TEPPANYAKI
Company Address/Alamat Perusahaan: jl H.R. RASUNA SAID Company Address/Alamat Perusahaan: jl. PEMUTIH, LABUAN
kav.X-0 KUNINGAN JAKARTA 12950 SAIT, ULUWATU. BALI-INDONESIA

Tel: (Office/kantor) (021) 526 8080 (Res/Rumah) 081384568925 Tel: (Office/kantor) (0361)8957 555 (Res/Rumah) 081238551509
Years of Acquintance/Lama Kenal: 4 years Years of Acquintance/Lama kenal: 4 years

Name of companies with which you have pending applications for employment
Sebutkan nama perusahaan lain yang Anda lamar
(Give dates of applicant/Tanggal melamar)
1. HOTEL INTERCONTINENTAL JIMBARAN-BALI
2.HOTEL PADMA LEGIAN-BALI
3.-

Have you applied with this office before? (State date)

Apakah Anda sebelumnya pernah melamar ke kantor ini? (Tanggal Melamar) Yes/Ya No/Tidak

I HEREBY CONFIRM ALL THE ABOVE DETAILS TO BE TRUE AND CORRECT. I AUTHORISE MELIA BANDUNG TO CARRY
OUT REFERENCE CHECK WITH PAST EMPLOYER AND REFEREES IN CONNECTION WITH THIS APPLICATION.
I UNDERSTAND THAT ANY MISPRESENTATION OR MISSION OF INFORMATION WILL BE SUFFICIENT REASONS FOR
WITHDRAWL OF AN OFFER OR SUBSEQUENT DISMISSAL, IF EMPLOYED.
SAYA MENYATAKAN BAHWA SEMUA INFORMASI YANG ADA ADALAH BENAR DAN TEPAT. SAYA MENGIJINKAN MELIA
BANDUNG UNTUK MEMERIKSA REFERENSI SAYA DENGAN PERUSAHAAN YANG MEMPEKERJAKAN SAYA SEBELUMNYA
DAN MEMUTUSKAN SEGALA SESUATU YANG BERHUBUNGAN DENGAN APLIKASI INI.
SAYA MENGERTI JIKA INFORMASI YANG DISAJIKAN ADALAH TIDAK BENAR MAKA AKAN BERAKIBAT DIBATALKANNYA
PENAWARAN KERJA ATAU PEMUTUSAN HUBUNGAN KERJA APABILA SAYA SUDAH DIPEKERJAKAN.

Date/Tanggal: 21 JUNE 2018 Signature/Tanda tangan: