Jl. Kamal Raya No.1, Kel.

TegalAlur
Kec.Kalideres
Jakarta Barat 11820
Employee Information Database PT.SJP Tel : (6221) 55 500 20
Fax : (6221) 55 510 73
I. PERSONAL IDENTITY ( IDENTITAS PRIBADI )

Full Name : Nick Name :

NamaLengkapFirst ( Given Name ) / Depan Middle / Tengah Last / Surname / MargaNamaPanggilan

Previous Name :.
( NamasebelumGantiNama )First / Depan Middle / Tengah Last / Akhir / Marga

Place of Birth : Date Of Birth :

KotaTempatKelahiran Tanggal, Bulan&TahunLahir
Gender : Male Female Religion :
JenisKelaminLaki – LakiPerempuan Agama / Kepercayaan

Nationality :Indonesia Height :

Kewarganegaraan TinggiBadan
Blood Type : E-mail Address :
GolonganDarah A B O AB Alamat E-mail

N.I.K (KTP) No. : N.I.K. Valid Date :

Nomor N.I.K ( KTP ) MasaBerlakuKTP sampai
dengan
: Single Engagement, Date : // Married, Date : //
Marital Status
Status PerkawinanLajangBertunangan, TanggalMenikah, Tanggal
: Divorced, Date : // Widow / Widower, Date : //
Bercerai, TanggalDuda / JandaTanggal
: A No. : Valid Date :
Driving Liscence
: C No. : Valid Date :
SIM Kendaraan
: B-1 No. : Valid Date :

Fixed Address
AlamatTetap ( KTP )

RT / RW : /City : ZIP Code

Kota KodePos
Home Phone-1 :( ) Home Phone-2 :( )
Cell Phone/HP-1 :( ) Cell Phone/HP-2 :( )
CDMA-1 No. :( ) CDMA-2 No. :( )
Home Fax. No. :( ) Other Number :( )

CURRENT
ADDRESS
AlamatTinggalSekarang

RT / RW : /City : ZIP Code

Kota KodePos

Home Phone-1 :( ) Home Phone-2 :( )

Cell Phone/HP-1 :( ) Cell Phone/HP-2 :( )
CDMA-1 No. :( ) CDMA-2 No. :( )
Home Fax. No. :( ) Other Number :( )
House Ownership
Status : MilikPribadi MilikKeluarga RumahKontrakan Pondokan / Kos
Status KepemilikanRumah Private Owned Family Owned Rent House BoardingLain-Lain

II. FAMILY IDENTITY ( IDENTITAS KELUARGA )

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 Jl. Kamal Raya No.1, Kel.TegalAlur
Kec.Kalideres
Jakarta Barat 11820
Employee Information Database PT.SJP Tel : (6221) 55 500 20
Fax : (6221) 55 510 73

Spouse’s Name :
NamaIstri / SuamiFirst ( Given Name ) / Depan Middle / Tengah Last ( Surname ) / Marga
Place of Birth : Date Of Birth
KotaTempatKelahiran Tanggal, Bulan&TahunLahir
Current Spouse’s
Occupation :
Perusahaan TempatSekarangIstri / SuamiBekerja Kota
Spouse’s Work
Place Phone : Spouse’s Cell Phone :
NomorTelp. TempatKerjaSuami / Istri NomorHPSuami / Istri
Religion : Have Kids ? : Yes, ( ) No Not Yet
Agama / Kepercayaan PunyaAnak ? YaTidakBelum
Do you have other dependent other than your spouse &kids ? Yes, ( ____ ), How much ( Rp. ____________________ ,- ) No
Apakahandamempunyaitanggungan lain selainistri / suamidan anak2 ? Ya, berapaorang? Berapajumlahtanggungan per bulan ? Tidakada

KID’S NAME PLACE, DATE OF BIRTH EDUCATION

NO Tempat, TanggalLahir Pendidikan
NamaAnak

1.
2.
3.
4.
5.

FULL NAME RELATION DATE OF BIRTH LAST EDUCATION OCCUPATION

NO NamaLengkap Hubungan PendidikanTerakhir Pekerjaan
TanggalLahir

1. Father
Ayah
2. Mother
Ibu
3. Guardian
Org TuaWali
4. Guardian
Org TuaWali
THE NEXT OF KIN ( SAUDARA KANDUNG ) Notes : K = Kakak ( Elder Brother / Sister ) ; A = Adik ( Younger Brother / Sister )

1. K / A

2. K / A

3. K / A

4. K / A

5. K / A

6. K / A

7. K / A
III. EMERGENCY CONTACT INFORMATION ( INFORMASI KONTAK DARURAT )
Full Name : Nick Name :
NamaLengkapFirst ( Given Name ) / Depan Middle / Tengah Last ( Surname ) / Akhir / MargaNamaPanggilan

Fixed Address
AlamatTetap ( KTP )

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 Jl. Kamal Raya No.1, Kel.TegalAlur
Kec.Kalideres
Jakarta Barat 11820
Employee Information Database PT.SJP Tel : (6221) 55 500 20
Fax : (6221) 55 510 73

RT / W : /City : ZIP Code

Kota KodePos
Home Phone-1 :( ) Home Phone-2 :( )
Cell Phone/HP-1 :( ) Cell Phone/HP-2 :( )
CDMA-1 No. :( ) CDMA-2 No. :( )
Home Fax. No. :( ) Other Number :( )
Relationship : Family / The Next of Kin Relatives Friend Guardian Other : ( )
HubunganKeluarga / SaudaraKandungKerabatTemanWali Lain-Lain

IV. FORMAL EDUCATION ATTAINTMENT ( RIWAYAT PENDIDIKAN FORMAL )

GRADU
NO FROM UNTIL NAME OF SCHOOL / ACADEMIC / UNIVERSITY MAJORITY CITY / COUNTRY
Dari Sampai NamaSekolah / Akademi / Universitas Jurusan Kota / Negara ATE
Lulus / Tidak

1.
2.

3.

4.

5.

6.

7.

V. NON - FORMAL EDUCATION ATTAINTMENT ( RIWAYAT PENDIDIKAN NON – FORMAL / KURSUS )

CERTIFI
NO NAME OF COURSE / TRAINING INSTITUTE TRAINING PERIOD CITY / COUNTRY
Judul / TemaPelatihan ( Training ) / Kursusygdiikuti BadanInstitusi / BadanPelatihan LamanyaPelatihan / Kursus Kota / Negara CATE
Ada / Tidak

1.
2.

3.

4.

5.

6.

7.

8.

9.

VI. FOREIGNLANGUAGE& MOTHER TONGUE ( PENGUASAAN BAHASA ASING, DAERAH & IBU )
LANGUAGE EXCELLENT GOOD / ACTIVE AVERAGE / PASSIVE INSUFFICIENT
NO Bahasa
Spoken & Written Active Spoken Active, Written adequate Spoken & Written Sufficient / Adequate Spoken & Written insufficient
SangatBaik ( Lisan&Tulisan ) LancarLisan, TulisanSedang Lisan&Tulisansedang Tidakmenguasailisan&tulisan

1.
2.

3.

4.

5.
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 Jl. Kamal Raya No.1, Kel.TegalAlur
Kec.Kalideres
Jakarta Barat 11820
Employee Information Database PT.SJP Tel : (6221) 55 500 20
Fax : (6221) 55 510 73

VII. EMPLOYMENT HISTORY ( RIWAYAT PEKERJAAN )

WORK PERIOD PLACE / LAST SALARY
NO COMPANY NAME JOB TITLE REASON
Nama Perusahaan
Lama Bekerja
Jabatan / Posisi CITY GajiTerakhir ( Take
AlasanPindah
( darisampaidengan ) Tempat / Kota Home Pay / Nett )

1.

2.

3.

4.

5.

6.

7.

8.

VIII.TESTIMONIAL / REFERENCE ( REFERENSI )

RELATIONSHI
NO NAME COMPANY JOB TITLE TELP. NO NOTES
Nama Nama Perusahaan Jabatan / Posisi Nomortelepon P Catatan
Hubungandgnanda

1.
2.

3.
4.

5.

6.

7.

1. Describe your job’s function / responsibility in your last position :

Uraikanpokok-pokoktugas / tanggung-jawabdarijabatanterakhirsaudara / saudari

_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
________
_____________________________________________________________________________________________
____
_____________________________________________________________________________________________
____

2. Describe the number of your sub-ordinates within the last 2 ( two ) years :
Sebutkanberapajumlahbawahan yang pernahsaudara / saudaripimpindalam 2 tahunterakhir

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 Jl. Kamal Raya No.1, Kel.TegalAlur
Kec.Kalideres
Jakarta Barat 11820
Employee Information Database PT.SJP Tel : (6221) 55 500 20
Fax : (6221) 55 510 73
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_______
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
____________

3. Describe your achievement or improvement you have been made in your former employments :
Uraikanprestasiatauperubahan / perbaikan / pembaharuan yang pernahandalakukan di perusahaan-perusahaansebelumnya

No / Tidakpernah Yes / Ya ( Describe / Uraikan)

_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
____________________

4. What position or title you applied for in this company? Give your reason to apply this position / title.
Posisiataujabatanapa yang saudara / saudarilamar di perusahaanini ? Berikanalasanmengapasaudara / saudarimelamarposisi / jabatantersebut

_____________________________________________________________________________________________
___
_____________________________________________________________________________________________
___
_____________________________________________________________________________________________
_____________________________________________________________________________________________
________
_____________________________________________________________________________________________
____

5. Describe what do you know about the task & responsibility of the above position.
Uraikanapa yang saudara / saudariketahuitentangtugasdantanggungjawabjabatantersebut

_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
________________________
_____________________________________________________________________________________________
____

6. Your favorite working environment : Reason :

Lingkungankerja yang saudara / saudarisenangi : Alasan / sebab-sebabnya

Factory Field Office Laboratory

Pabrik Lapangan PerkantoranLaboratorium

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 Jl. Kamal Raya No.1, Kel.TegalAlur
Kec.Kalideres
Jakarta Barat 11820
Employee Information Database PT.SJP Tel : (6221) 55 500 20
Fax : (6221) 55 510 73
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
____________
_____________________________________________________________________________________________
____
_____________________________________________________________________________________________
____

7. Your un-favorite working environment : Reason :

Lingkungankerja yang tidaksaudara / saudarisenangi : Alasan / sebab-sebabnya

Factory Field Office Laboratory

Pabrik Lapangan PerkantoranLaboratorium

_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
____________
_____________________________________________________________________________________________
____
_____________________________________________________________________________________________
____

8. What is your life-dream or your life’s destination ?

Apacita-citaatautujuanhidupsaudara / saudari
_____________________________________________________________________________________________
____
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
________________

9. What is your hobby ?

Apahobisaudara / saudari ?
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
____________________

10. In which circumstances you have difficulty to make decision ?

Dalamhal – halapasajaataudalamkondisibagaimanakahsaudara / saudarisulitmengambilkeputusan ?
_____________________________________________________________________________________________
___
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
________________

11. Describe each minimum 3, your strong and weak point ( need to be improved ) ?
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 Jl. Kamal Raya No.1, Kel.TegalAlur
Kec.Kalideres
Jakarta Barat 11820
Employee Information Database PT.SJP Tel : (6221) 55 500 20
Fax : (6221) 55 510 73
Uraikanmasing-masing minimum 3 yang menjadikekuatan / kelebihandankelemahan ( faktor-faktor yang perludiperbaiki / ditingkatkan ) saudara / saudari

Strong Point : Weak Point :

_____________________________________________________________________________________________
____
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
________________

12. Have you ever been abroad ? No / Tidakpernah Yes / YA, describe when, how long, in what
purpose :
Apasaudara / saudaripernahkeluarnegeri ? Bila “YA”, sebutkankapan, berapa lama, danuntukkeperluanapa ?

________________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
________________
_____________________________________________________________________________________________
____
IX. ORGANIZATION ( ORGANISASI YANG PERNAH DIIKUTI )
NO ORGANIZATION NAME CITY / COUNTRY TITLE / STATUS PERIOD REMARKS
NamaOrganisasi / Serikat Kota / Negara / Tempat Jabatan / Status Periode Keterangan
1.
2.
3.
4.
YANG PERNAH DIIKUTI )
X. INTERN COMPANY ( INTERNAL PERUSAHAAN )

1. What is your expectation salary ( Take Home Pay ) ? Negotiable ? No / Tidak Yes / Ya
BerapaGajibersih yang saudara / saudariharapkan ( Take Home Pay ) ? Dapatdirundingkan / dinegosiasi ?
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
_________

2. What facilities you wish? ( To be noticed : Terms and Conditions will follow Company’s Policies & shall be
discuss
Fasilitiasapayang saudara / saudariharapkan ?
___________________________________________________________________________________________________
___
___________________________________________________________________________________________________
___
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
_________

3. When you will able to joint / start to work if you hired?

Kapankahsaudara / saudaridapatmulaibekerrjaapabilaandaditerima di perusahaanini ? ___________________________________________________________________________________
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 Jl. Kamal Raya No.1, Kel.TegalAlur
Kec.Kalideres
Jakarta Barat 11820
Employee Information Database PT.SJP Tel : (6221) 55 500 20
Fax : (6221) 55 510 73
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
________

4. Do you agree to be transferred to other unit / branch / affiliates company and / or out of town ( Jakarta ) ?
Bersediakansaudara / saudariditempatkan di unit-unit yang lain atau di luarkota ?

Yes / Ya No / Tidak,Why / Describe your reason ? / Mengapa / sebutkanalasananda :

___________________________________________________________________________________________________
___
___________________________________________________________________________________________________
___________________________________________________________________________________________________
______

5. Do you mind for business trip to other unit / branch / affiliates company and / or out of town ( Jakarta ) ?
Apakahandabersediamelakukanperjalanandinaske unit-unit yang lain ataukeluarkota ( daerah – daerah ) ?

Yes / Ya No / Tidak,Why / Describe your reason ? / Mengapa / sebutkanalasananda :

___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
_________

6. Do you have any vehicle ? Yes / Ya : Car / Mobil Motorcycle / Motor No / Tidak
Kendaraanapa yang saudara / saudarimilikisaatini ?
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
_________

7. Have you ever send your resume before to this company ?When & for what position? No/Tidak Yes/Ya
Pernahkahsaudara / saudarimengirimkanlamarankeperusahaaninisebelumnya ? Kapandanuntukposisiapa ?

_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________

8. Have you ever been hospitalized or had sick for long time ? No/Tidak Yes/Ya, Describe it
Pernahkahsaudara / saudaridirawat di rumahsakitataumenderitasakit / sakitkerasuntukwaktu yang lama ? Jelaskankapan, di mana&apapenyakit yang diderita
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
_________

Jakarta, / / 2022

( )

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