APPLICATION FORM
ATC/2024/19/289
PERSONAL DETAILS
Full Name
*
Sex
Male
Female
*
Place, Date of Birth
*
Religion
Islam
Kristen
Hindu
Budha
Others
*
Nationality
WNI
WNA
Ethnic
Martial Status
Single
Married
*
CURRENT MAILLNG ADDRESS
PERMANENT MAILLNG ADDRESS
Own House
Rented House
Parents
Others
Own House
Rented House
Parents
Others
Telp. No. (Off)
(Res)
Telp. No. (Off)
(Res)
(H/P)
*
Fax.
(H/P)
Fax.
Email :
*
Email :
Driver License A/No.
Do you own a car :
Yes
No
FAMILY AND ASSOCIATION DETAILS
Relationship
Name
Age
Last Education
Occupation
Father
*
Mother
*
Husband/Wife
Child
Brothers/Sister
Is there any family or relatives working for PT Lion Group? If yes, please give details in table below:
RELATIONSHIP
NAME
UNIT/DEPARTMENT
AREA/DISTRICT
EDUCATIONAL BACKGROUND
From - To
Schools, Collage, Universities
Major
GPA
Diploma
(Yes/No)
Yes
No
Yes
No
Yes
No
Yes
No
SEMINAR/COURSE/WORKSHOP
From - To
(States dates)
Topic
Organizer & Location
Certificate
(Yes/No)
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
WORKING EXPERIENCE
* Please state in chronolical order of your work experience beginning with the latest or
present employment.
Start Date - End Date
Company
Job Category
EMPLOYMENT RECORD
Date of Employment:
Date Employment Ended:
Company Name
Address
Business Line
Current/Latest Position
Report directly
(Name/Position)
/
Number of Sub-Ordinates
person(s)
Main Job Responsibilty
Achievement
How did you get emplyoed
Through Advertisement
Recomendation
Etc
Reason for leaving
Last Drawm Salary
ADDITIONAL INFORMATION
SPECIAL ACTIVITIES
From - To
Name of Organization
Place
Position
SKILLS
(Languages, Technical, Computer, etc)
TYPE OF SKILLS
LEVEL OF PROFICIENCY
Languages
Technical
Computer
Etc
Basic
Intermediate
Advanced
Languages
Technical
Computer
Etc
Basic
Intermediate
Advanced
Languages
Technical
Computer
Etc
Basic
Intermediate
Advanced
Languages
Technical
Computer
Etc
Basic
Intermediate
Advanced
OTHER PERSONAL INFORMATION
What are you doing in your leisure time?
How often do you read?
Very often
Occasionally
Rarely
Never
What is your point of interest?
Have you ever been charged or convicted of any criminal offence?
Yes
No
Do you have any objections to a criminal record check being conducted?
Have you been dismissed or suspended from any position?
Yes
No
If so, state details:
Have you ever suffered from any serious medical condition eg. tuberculosis, diabetes, asthma or epilepsy?
Yes
No
If YES, please explain the condition:
Have you ever experienced any physical or emitional illness which may impair your work performance?
Yes
No
If YES, what is the nature of your illness?
Do you have any special medical needs?
Yes
No
If YES, what is the nature of this requiremenet?
REFERENCES
NAME
POSITION
COMPANY
ADDRESS/PHONE
ATTACHMENT
EDUCATIONAL BACKGROUND
SMA
SMK
Subjects
Average value
Total
CLASS X
CLASS XI
CLASS XII
Mathematics
Physics
Recently GPA
ACADEMY
:
Recently GPA
UNIVERSITY
:
Recently GPA
CHECKLIST COMPLETED APPLICATION FORM
Application Letter (In Hand Writing & Stamped)
Statement Form
Curriculum Vitae
[Copy] Legalized of Grade Report Cards and Transcripts Grade
[Copy] TOEFL (With Minimum Score 450)
[Copy] Family and ID card
[Original] Legalized of Police Notes (SKCK)
[Original] Drug-Free Original Certificate
[Original] Unmarried Original Certificate
[Original] Original Certificate of No Color Blind Eye
2 (two) pieces 4X6 recent photograph
Postcard size, color photos of the whole body/3R
Show PDF
All files will be uploaded please be in one file in PDF format
Need Help ???
I accept and agree to the Terms and Conditions Angkasa Training Center