FORMULIR LAMARAN KERJA

EMPLOYMENT APPLICATION FORM

Posisi yang dilamar / Position applied : Tanggal / Date :
__________________________________ ___________________________
DATA PRIBADI Personal Data
Nama Lengkap ___________________________ Laki-laki Wanita
Full Name Male Female
Tempat Tanggal Lahir ___________________________ Warga Negara __________________________
Place & Date of Birth Nationality
Status Perkawinan ___________________________ Tinggi/Berat __________________________
Marital Status Height/Weight
Agama/Religion ___________________________ Gol.Darah/Blood type _______________________
Religion Blood Type
ALAMAT Address
Alamat Tetap Permanent Address Alamat Surat Mailing Address
_______________________________________________ ___________________________________________
_______________________________________________ ___________________________________________
No. Tlp / Ph number ___________________________ No. Tlp/Ph number __________________________
E-Mail ___________________________ E-Mail __________________________
PENDIDIKAN FORMAL Formal Education
Jenis Sekolah Nama Sekolah Kota Jurusan Lulus Tahun
Type of School Name of Institute City Major Year of Grad.
SLTP ___________________________ _____________ __________ ____________
SLTA ___________________________ _____________ __________ ____________
D1 / D2 / D3 / D4 ___________________________ _____________ __________ ____________
S1 / S2 ___________________________ _____________ __________ ____________
KETRAMPILAN INFORMAL
Jenis Ketrampilan Baik / Cukup / Kurang Spesifikasi/Specification
Komputer
Bahasa Asing
Lain-lain
DATA IDENTITAS Identity Data
No. KTP/Id Card No ___________________________ No. SIM/DL No ___________________________

Berlaku sampai ___________________________ No. Rekening Tab ___________________________

DATA KELUARGA Family Data
Nama Ayah/Ibu : ______________________________ Nama Anak :
Pendidikan : ______________________________ Anak ke-1 : __________________________
Pekerjaan : ______________________________ Usia : __________________________
Alamat ______________________________ Anak ke-2 : __________________________
Nama Istri / Suami : ______________________________ Usia : __________________________
Pendidikan : ______________________________
Pekerjaan : ______________________________ Anak ke-3 : __________________________
Alamat : ______________________________ Usia : __________________________
PELATIHAN Training
Nama / Jenis Pelatihan Penyelenggara Bulan/Tahun
Name/Type of Course Organizer/Location Month/Year
____________________________________________ ____________________________ _____________
____________________________________________ ____________________________ _____________
____________________________________________ ____________________________ _____________
LAIN-LAIN Others
Apakah Saudara pernah menderita penyakit serius ? ________________________________________
Have you ever suffered from a serious illness ? Jenis Penyakit Bulan/Tahun menderita peny.tsb
Type of Illness Month/Year suffering illness
_______________ ___________________________

_______________ ___________________________

PENGALAMAN KERJA Working Experiences

Nama Perusahaan Jabatan/Gol Dari-Sampai (Th) Gaji Alasan Berhenti

Company Name Position/Level From - To (Year) Salary Reason of Leaving

___________________ ______________________________ ____________ ___________ _______________

___________________ ______________________________ ____________ ___________ _______________

___________________ ______________________________ ____________ ___________ _______________

___________________ ______________________________ ____________ ___________ _______________

___________________ ______________________________ ____________ ___________ _______________

___________________ ______________________________ ____________ ___________ _______________

___________________ ______________________________ ____________ ___________ _______________

Gaji Terakhir : _______________________ Tgl.:Bisa

_______________________
Mulai Bekerja
Latest Salary Available Date

Gaji Yang Diharapkan : _______________________

Expected Salary
REFERENSI Reference
Nama Telpon Perusahaan Posisi / Dept. Hubungan

___________________ ______________________ ___________________________

___________________________
_______________

___________________ ______________________ ___________________________

___________________________
_______________

Dengan ini Saya menyatakan bahwa data di atas ditulis dengan benar. Apabila dalam masa kerja nanti diketahui
bahwa data tersebut tidak benar / dipalsukan, maka Perusahaan dapat memutuskan hubungan kerja tanpa harus
membayar uang pesangon / jasa maupun ganti rugi dalam bentuk apapun.
I hereby certify that information provided herein is true to the best of my knowledge. In the event of employment, I understand
that false or misleading information provided in my application may result in termination of my employment without receiving
severance / service pay and / or compensation of any kind.

_______________________________
Nama & Tanda tangan Pelamar
Name & Signature of Applicant