FORMULIR PERMINTAAN KARYAWAN

NO : ......... / FPK-PERSONALIA / RSSH / ...... / 20.......

Departemen/Bagian/Divisi :....................................................................... Tanggal Pengajuan :...........................................

Posisi / Jabatan :....................................................................... Tanggal Dibutuhkan :...........................................
Jumlah Permintaan :.............................................................Orang Status : Tetap Kontrak

Keterangan permintaan karyawan : Keterangan:

Mengganti Karyawan Nama Karyawan :............................................ Mengundurkan Diri Dikeluarkan Karena................
Penambahan Karyawan Keterangan :..................................................................................................................................................
Kerja Waktu tertentu : ....................Tahun ................................Bulan
Lainnya Keterangan :..................................................................................................................................................

Dampak Kekosongan Posisi / Jabatan :

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Sumber Rekrutmen : Internal Eksternal Outsource

Deskripsi Pekerjaan
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Kualifikasi Pendidikan
Status : Menikah Belum Menikah
Usia : .................... s/d ....................... Tahun
Pendidikan : SMA/K Dipolma........ S1 S2 Lainnya................................
Keahlian Khusus : 1. .............................................................................................................................................................
2. .............................................................................................................................................................
3. .............................................................................................................................................................
4. .............................................................................................................................................................
Sertifikat/Pelatihan : 1. .............................................................................................................................................................
2. .............................................................................................................................................................
3. .............................................................................................................................................................
4. .............................................................................................................................................................
Kecakapan Bahasa : 1. Indonesia :................................ K : Kurang
2. English :................................ C : Cukup
B : Baik
3. ..................... :................................
Pengalaman Kerja : ˂ 1 tahun 1-2 tahun 2-3 tahun 3-5 tahun 5 ˂ tahun
Tambahan :.....................................................................................................................................................................
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Kisaran,...................................................

Pemohon Mengetahui Menyetujui

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Departemen/Divisi/Bagian Direktur Personalia