BIODATA CALON ANGGOTA

SATUAN PENGAMANAN / SATPAM

PT. PUTRA DEWATA MANDIRI Grade / Level
Reg. Nomor : ...........................................................................................
Asuransi BPJS/Dll : ................................................................................................................................................

NIK KTP / ID lain : ................................................................................................................................................

Nama lengkap : ................................................................................................................................................

Nama panggilan : ................................................................................................................................................ Photo 4X6

Tmpt / Tgl. Lahir : ................................................................................................................................................
BG. Merah
Agama : ................................................................................................................................................

Status perkawinan : ................................................................................................................................................

Jumlah anak : ................................................................................................................................................

Nomor HP pribadi : ............................................................................................................. E-Mail : .........................................................................

Nomor HP kerabat : Hubungan ...................................................... / ......................................................................................................................

Alamat sesuai KTP : .........................................................................................................................................................................................................

Alamat saat ini : .........................................................................................................................................................................................................

Pekerjaan saat ini : 1. ................................................................................................................................................................................................

2. ................................................................................................................................................................................................

Tinggi badan : ..................................... Cm Riwayat sakit keras : ................................................................................

Berat badan : ..................................... Kg Kesehatan saat ini : ................................................................................

Golongan darah : .....................................

Letak tattoo : .......................................................................................................................................................................................................

Riwayat kriminal : .......................................................................................................................................................................................................

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SKCK : .............................................. Pendidikan terakhir : ................................................................................

SERTIFIKASI : KTA / GADA PRATAMA / GADA MADYA / GADA UTAMA / TIDAK ADA SERTIFIKASI
Pengalaman Kerja : 1. ................................................................................................................................................................................................

2. ................................................................................................................................................................................................

3. ................................................................................................................................................................................................

4. ................................................................................................................................................................................................

5. ................................................................................................................................................................................................

Denpasar, ........... / ........................................ / ................

Hormat Saya

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