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HR001 Application Form PT.TOA PAINT INDONESIA

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Application No.
TOA PAINT GROUP OF COMPANIES
Application Form
Should be completed in English for applicant who is able to write
Should be read through first, then complete
Application Date
(dd-mm-yyyy)
Position applied for 1)_____________________
2)_____________________
How many prior notification day
3)_____________________
Name and surname in Burmese (Mr./Mrs/Ms/
Other (specify) ________
Name_____________ Surname____________
PHOTO
1”- 2”
Expected Salary ______________ (IDR)
____________Days
Name and surname in English (Mr./Mrs/Ms/Other (specify) ________
____________________
Name
_______________________
Surname
Nationality/Race
Birthday
Age
Place of birth (Province)
___________________
______________________
_____________
_______________________________
Household residence registration address
______________________________________________
Current Address
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________ Postal code ______________
Postal code ____________________________________
Desktop number _______________________________
Home number _________________________________
Mobile Number _________________________________
Mobile Number _________________________________
Person to be notified in case of emergency____________
Contact number__________________________________
Personnel data
Identification card number______________________
Issued date
________________________________
Issued by
________________________________
Province
_________________________________
Expired Date
________________________________
Tax ID _______________________________________
Height
__________________CMS
Marital status
Single
Married
Weight
__________________KGS
Divorced
Separated
Spouse’s name
Have you ever been in military service
or except ?
____________________
________________________
Number of Children
Would you mind be transferred to up
country?
____________________
_________________________
Education and Training Background
Educational Level
Year Graduated
Institution/Province
Degree
Major
GPA.
Primary
High School/Vocational
High Vocational/Diploma
Bachelor
Master
Other (Specify)
English knowledge and other language
Speaking
Language
Excellent
Good
Reading
Fair
Excellent
Understanding
Good
Fair
Excellent
Good
Fair
Excellent
Good
Fair
Poor
English
Other (Specify)
___________________
Computer literacy
Program
MS Word
MS Excel
MS Power Point
MS PageMaker
Adobe Illustrator/Photoshop
Other program (Specify)
Word typing per minute
BAHASA ____________________________________________wpm. ENGLISH_______________________________________ wpm.
Driving and License
Motorcycle
License No._______________________ Your owner
Yes
No
Sedan
License No._______________________ Your owner
Yes
No
Tanker
License No._______________________
Any , (Specify) ________________ License No._______________________
Special skill (Specify)
Latest employment background
Name of company
Business Type
__________________________________
_____________________________________
Date of employment
from ______________________________ to ________________________________
Job description
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
Benefit Type
Social Security
Latest Position
Latest Salary
______________________
______________
Total service year
________________________________________
Reason for leaving
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
Supervisor’s name/Position
________________________
________________________
________________________
________________________
Uniform
House Allowance
Mobile Allowance
Health Insurance
Location Allowance
Provident Fund
PPE
Meal Allowance ________
Synergy Allowance
Transportation
Other (Specify)————————
Name of company
Business Type
Latest Salary
Latest Position
______________________________________ ___________________________________________ _________________________ ________________________
Date of employment
from ______________________________ to ________________________________
Job description
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
Benefit Type
Social Security
Total service year
________________________________________
Reason for leaving
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
Supervisor’s name/Position
________________________
________________________
________________________
________________________
Uniform
House Allowance
Mobile Allowance
Health Insurance
Location Allowance
Provident Fund
PPE
Meal Allowance
Synergy Allowance
Transportation
Other (Specify)
Hobbies/Sports
Club’s Membership/Association
________________________________________________________________ ________________________________________________________________________
Date of latest accident case, please describes ____________________________________________
__________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________
Reference person who is not your relatives (2 persons at least)
1)_____________________________________________________
Name-Surname
____________________________________
Occupation
_____________________________
Contact number
2)_____________________________________________________
Name-Surname
____________________________________
Occupation
_____________________________
Contact number
Condition
I certify that I have given true, accurate and complete information this application form to the best of my acknowledge. In the event confirmation is needed
in connection with my qualification , I authorized employers, educational institutions, associations, registration and licensing boards, and other whatever
detail is available concerning my qualifications. I authorized investigation of all statements made in this application, disciplinary action or employment
termination, I further understand that dismissal upon employment shall be mandatory if truculent disclosure are given to meet position qualification
Applicant’s signature _______________________________________________________________
Date_______________________
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