FORMULIR LAMARAN KERJA

EMPLOYMENT APPLICATION FORM

PENTING: BACALAH PETUNJUK INI DENGAN TELITI SEBELUM MENGISI FORMULIR

Isilah semua informasi yang diminta. Informasi yang Anda berikan akan digunakan untuk menentukan kelayakan Anda pada
pekerjaan yang dilamar. Penting bagi Anda untuk menjawab semua pertanyaan dengan lengkap dan tepat. Bila tidak
dilakukan, akan bisa memperlambat proses pertimbangan dan mungkin menghilangkan peluang Anda. Bila ada bagian yang
tidak berlaku lagi bagi diri Anda atau ada informasi yang tidak perlu diberikan, harap diisi dengan T/B (Tidak Berlaku). Anda
yang biasa berbahasa Inggris diminta untuk mengisi formulir ini dalam bahasa Inggris.

IMPORTANT: READ THE FOLLOWING INSTRUCTIONS CAREFULLY BEFORE FILLING OUT THE FORM
All required information must be furnished. The information given will be used to determine your qualifications for
employment. It is IMPORTANT that you answer all questions completely and accurately. Failure to do so may delay its
consideration and could mean loss of employment opportunities. If an item does not apply to you, or if there is no information
to be given, please write N/A (Not Applicable). Those who are able to write in English must complete the form in English.

TanggalPermohonan / Date of Application : September 7th 2021

DATA PRIBADI
PERSONAL DATA
NamaLengkap Posisi yang diinginkan Gaji yang diharapkan
Full Name Position applied Expected salary
Selfin Untu 6- 7 Million/ Month
1. _ FB Administration

2. _____________________________________

NamaPanggilan Tempat&TanggalLahir Umur Kewarganegaraan Agama

Nickname Place & Date of Birth Age Nationality Religion
Selfin Wiau,September 27th 1977 43th Indonesian Adventist Christian

JenisKelamin/Gender □ L/Male□ P/Female AlamatTetap AlamatSekarang

Tinggi/Height …160………… cm Permanent Address Present Address
Berat/Weight ……57……… kg Jln Berkat Koka jaga 5
Berkacamata/Spectacled Telephone :
□Ya/Yes□Tidak/No Telephone :081356418451

No. Handphone : 081356418451 No. NPWP :N/A No. BPJS Kesehatan :

N/A

Golongan Darah / Blood Type :O No. SIM / Jenis SIM / Driver's License: No. BPJS Ketenagakerjaan :
A / B1 / B2 / C / D N/A
N/A

Status Perkawinan / Marital Status No. KTP / ID Card No. Status Rumah / Residence
□ Belum Menikah / Single 7102146709770001 □Milik Orang Tua / Live With Parents
□ Menikah / Married □MilikSaudara / Live With Relatives
□ Cerai / Divorced □MilikTeman / Live With Friends
Dikeluarkan di / Issued in MilikSendiri / Own House
□ Janda/Duda / Widowed
Minahasa □Sewa (Kost) / Rent (Boarding House)

Berlakusampai / Expiry Date

NamaSuami / Istri NamaAnak-anak&Umur Nama Ayah / Father’s Name

Spouse’s Name Ronald Wewengkang A.Md Children’s Name & Age Hendrik Untu
1. Vinny Rose Veronica Wewengkang
2. Matthew Vinno Rosi Valentino Wewengkang Pekerjaan / Occupation
3. _____________________________________ Pass away
4. _____________________________________
5. _____________________________________
PekerjaanSuami / Istri 6. _____________________________________ NamaIbu / Mother’s Name
Spouse’s Occupation Ribka Rumalag

Pekerjaan / Occupation
Pass away

FOR OFFICE USE ONLY

Job Title _________________________________________________________ Human Resources Manager
Department ______________________________________________________
Department Head
Starting Date _____________________________________________________
General Manager
 Pay Rate __________________________________ per _________________ Director

1. PENDIDIKAN / LATIHAN / KELAYAKAN / KEMAHIRAN – EDUCATION / TRAINING / QUALIFICATIONS / SKILLS

Tahun Tingkat NamaInstitusiPendidikan Jurusan Ijasah / Gelar

Year Level Name of Educational Institution Major Diploma / Degree
1987 SekolahDasar SD GMIM Wiau
Primary School
1993 SMTP SLTP 4 Langowan
Junior High
SMU
Senior High
1996 SMK SMKK (SMK) Negeri 3 Tikala Manado Tourism/Hotel
Vocational
Akademi
College
2011 Universitas Sekolah Tinggi Ilmu Pariwisata ( STP) Tourism /Hotel
University
Lain-lain
Others
Lain-lain
Others
Kecepatan Mengetik Program Komputer / Computer Program Lain – Lain / Others
Typing Speed 35-40 WPM □ MS Word
□ MS Excell
Steno
□ MS Power Point
Shorthand 55- 75 WPM

Tuliskankemahiranatausertifikatlainnya / List other special skills or licenses

2. BAHASA – LANGUAGES

Pemahaman Berbicara Membaca Menulis

Bahasa Understanding Speaking Reading Writing
Language Baik Cukup Bur Baik Cukup Buruk Baik Cukup Buruk Baik Cukup Buruk
Good Fair uk Good Fair Poor Good Fair Poor Good Fair Poor
Po
or
English    

3. RIWAYAT PEKERJAAN (Mulai dari pekerjaan saat ini dan mundur ke belakang)
EMPLOYMENT RECORD(Start with your present job and work back)

Lama bekerja / Length of service Jabatan (Posisi) / Title (Position) Gaji per bulan / Salary per month
A. 3 Tahun / Year Bulan / Month march Banquet Coordinator 6 Million-7 Million
dari/from 2017 sampai/to 2021

Namadanalamattempatbekerja Nama dan Jabatan Atasan Langsung

Name and address of company Name and Title of Immediate Supervisor
Aryaduta Manado Roy Kundiman
Jln. Piere Tendean Boulevard Manado

Alasanberhentibekerja
Reason for leaving
Effect Covid 19

TugasUtama
Main job description
Handling Food & Beverage Service Administration
Parstock Of FB & Inventory Report to FB Manager & Cost Control
Coordination for the Cliient Event/Meeting
Coordination For the Staff Schedule & their job also staff needed during Event
 Lama bekerja / Length of service Jabatan (Posisi) / Title (Position) Gaji per bulan / Salary per
B. 6 Tahun / Year January Bulan / Month Senior Sales Executive month
dari/from 2011 sampai/to 2017 6 million-7 Million

Namadanalamattempatbekerja NamadanJabatanAtasanLangsung
Name and address of company Name and Title of Immediate Supervisor
Aryaduta Manado Olke Sumajow SE
Jln Piere Tendean Boulevard Manado
Alasanberhentibekerja
Reason for leaving

TugasUtama
Main job description
Handling Sales & Marketing Hotel Product
Handling Event/ Meeting, Social Event,Coorporate & Government Segmentation

Lama bekerja / Length of service Jabatan (Posisi) / Title (Position) Gaji per bulan / Salary per
C. 2 Tahun / Year April Bulan / Month Sales & Marketing Dept month
dari/from 2008 sampai/to 2010 Banquet Sales Executive

Namadanalamattempatbekerja NamadanJabatanAtasanLangsung
Name and address of company Name and Title of Immediate Supervisor
The Ritzy Hotel Maria Oley

Alasanberhentibekerja
Reason for leaving

TugasUtama
Main job description
Handling Client All Event /Meeting Client From Company & Goverment

Lama bekerja / Length of service Jabatan (Posisi) / Title (Position) Gaji per bulan / Salary per
D. ______5_____ Tahun / Year ___________ Bulan / Month FB Division month
dari/from 2003 sampai/to 2008
Captain Cakrawala Restaurant

Namadanalamattempatbekerja NamadanJabatanAtasanLangsung
Name and address of company Name and Title of Immediate Supervisor
The Ritzy Hotel Manado Jein Tanod

Alasanberhentibekerja
Reason for leaving

TugasUtama
Main job description
Handling Restaurant Operational
Administration of Restaurant & Bar Report to Fb Manager

4. REFERENSI (Tiga orang yang bukan saudara / keluarga) PEKERJAAN HUBUNGAN

REFEREES (Three people not relatives) OCCUPATION RELATIONS
Nama / Name Teacher ff
Inlen Felma Lengkong M.Pd
Friend & Patner In Ministries
Alamat / Address
 Teling Manado
Tel.081241490007

Nama / Name Teacher Friend &Patner in Ministries

Lesly Tololiu S.Pd
Tel. 085240107722
Alamat / Address
Koka Kec Tombulu

SNama / Name Doctor Patner in Women Ministries

Dr.Glady Rambert Sp. PK

Alamat / Address
Malalayang Manado
Tel.085299111234

5. NAMA ORANG YANG DAPAT DIHUBUNGI DALAM KEADAAN DARURAT

NAME OF PERSON IN CASE OF EMERGENCY

1. Nama / Name Ronald Wewengkang Hubungan / Relationship Husband

Alamat / Address Koka Kec. Tombulu Tel.: 081340096971
2. Nama / Name Agnes Untu Hubungan / Relationship Old Sister
Alamat / Address Koka Kec Tombulu Tel.: 0852191224025

6. SAUDARA KANDUNG / BROTHERS & SISTERS

Nama / Names Umur / Age JenisKelamin / Pekerjaan / Occupation

Gender
Agnes Agustina Untu 47th Female Company Employee
Elen Alrince Untu 33th Female Nurse

7. APAKAH ANDA MEMILIKI KELUARGA YANG BEKERJA PADA PERUSAHAAN INI ATAU PERUSAHAAN LAIN DIPT MANADO UNDERWATER
EXPLORATION ATAU PT. PRIMA EKA BAHARI ?
DO YOU HAVE RELATIVES WORKING WITH THE COMPANY OR OTHER COMPANIES OF MUREX GROUP?

NamaKeluarga / Name of Relatives Hubungan / Relationship Jabatan / Position Bagian / Department

8. SILAHKAN BERI TANDA UNTUK YA ATAU TIDAK YA TIDAK

MARK WITH ( √ ) FOR YES OR NO YES NO

Pernahkah Anda dipecat karena perilaku atau kerja Anda tidak memuaskan? 
Have you ever been discharged from employment because of you unsatisfactory conduct or work?
ApakahAndaterlibatdalamsuatubentukpenyalahgunaanobatterlarang? 
Are you involved in any kind / form of drug abuse?
ApakahAndamemilikikecacatanfisik, penyakitberatatauketidaknormalanlainnya? 
Do you have any physical handicaps, chronic diseases, or other disabilities?
Pernahkan Anda ditahan dan didakwa atas suatu perbuatan kriminal? 
Have you been arrested and convicted of crime?
(Untuk Wanita) Apakah Anda sedang mengandung / hamil? 
(For Female) Are you pregnant now?
Bolehkah kami menghubungiatasanAndasekarangdansebelumnyauntukmenanyakankualifikasidankarakterAnda? 
May we contact your present and previous employers to inquire regarding your qualifications and character?
Semuapernyataandanketerangan yang sayaberikandalamformulirpermohonankerjainiadalahbenar, lengkap,
danakurat.Segalaketeranganpalsuataujawaban yang
tidakbenaruntukpertanyaanmanapunbisadijadikandasarbagipemecatanlangsungdaripekerjaansayananti.

The statements I made in this form are true, complete, and accurate. False statements or dishonest answer to any questions may be made ground
for my immediate discharge from employment forthwith.

TandaTanganPemohon Tanggal
Applicant’s signature Date September 8th 2021
Catatan / Note

Semuabentukdokumen yang telahdikirimkan / dilampirkantidakdapatdimintakembali.

All documents submitted are not-returnable.