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_______________________
