DAFTAR RIWAYAT HIDUP

I. DATA PRIBADI
Nama : .................................................................................................
Tampat dan Tanggal Lahir : .................................................................................................
Jenis Kelamin : .................................................................................................
Alamat : .................................................................................................
Nomor Telepon/Ponsel : .................................................................................................
Alamat Email : .................................................................................................
Status Kepegawaian : ASN / Non ASN*
Jenjang Jabatan : (diisi bagi ASN yang bersatus sebagai
pejabat fungsional) Kategori
Keterampilan : Terampil / Mahir / Penyelia*
Kategori Keahlian : Pertama / Muda / Madya / Utama*
Keterangan: *) coret yang tidak perlu

II. RIWAYAT PENDIDIKAN

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2. .......................................................................................................
3. .......................................................................................................
4. .......................................................................................................

III. PENGALAMAN KERJA

1. .......................................................................................................
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