Human Resources Department
JOB APPLICATION FORM
I. POSITION APPLIED
Position : Store Manager
II. PERSONAL DATA
Full Name : IRMANSYAH
(Male / Female *)
Sex :
(striketrough the unnecessary)
Date of Birth : 10 Mei 1991 Place : Jakarta
Religion Islam Nation : Indonesia
Senior High School / Academy / University / Post Graduate *)
Last Education :
(striketrough the unnecessary)
ID Card Number : 317405100910001
NPWP Number : [Link]-013.000
C / A / B I / B II
Driving Lisence 1219190901682
(striketrough the unnecessary) Driving Lisence No :
Current Address : Jalan Bungur Raya no 58 RT 014
RW 001 Kebayoran Lama Selatan
Telephone : 0822 6037 5338 Phone :
E-Mail Address : [Link]@[Link]
In case of emergency, family, address, phone number that can be contacted:
: RENI ANGGRAINI
Name
Family Relation : ISTRI
Phone Number : 081285244131
Address : Jalan Bungur Raya no 58 RT 014
RW 001 Kebayoran Lama Selatan
Page 1 of 3
Human Resources Department
III. EDUCATION
Year
Education Level School / Institution Major
Start Graduate
SDN 02 PETANG KBY
SD 1998 2003
LAMA
SMP SMPN 164 JAKARTA 2003 2006
SMK SMK TRIGUNA UTAMA 2006 2009
IV. WORKING EXPERIENCE
Duration of Work
Company Name Last Position Last Salary Reason for Leaving
From Untill
PT ARISTA AUTO MENDAPATKAN
TEKNISI GR 2009 2013 1.500.000
PRIMA PEKERJAAN LEBIH BAIK
PT ASTRIDO JAYA
TEKNISI THS 2013 NOW 5.500.000
MOBILINDO
V. LANGUAGE SKILLS (Beginner, Intermediate, Advanced)
Language Reading Writing Speaking
English BEGINNER BEGINNER BEGINNER
VI. FAMILY DATA
Relation Name Date of Birth Education Occupation
Spouse RENI ANGGRAINI 08 APRIL 1989 S2 IBU RUMAH TANGGA
BILAL AL FATIH
Children 1 05 AGUSTUS 2018
SYAHPUTRA
UWAIS AL QARNI
Children 2 23 NOVEMBER 2020
SYAHPUTRA
BRIAN MAHAMERU
Children 3 20 FEBRUARI 2023
SYAHPUTRA
Father
Mother
Sibling 1
Sibling 2
Sibling 3
Page 2 of 3
Human Resources Department
VII. STRENGTH AND WEAKNESS
STRENGTH WEAKNESS
MANAGE WAKTU SPEAKING DAN READING ENGLISH
Yes / No *)
1. Are you still working? :
(striketrough the unnecessary)
2. Wage package expected (gross) : 7.000.000
3. When is your availability to work? : 01 JANUARI 2024
Yes / No *)
4. Do you able to be placed in our store? :
(striketrough the unnecessary)
Yes / No *)
5. Do you have relatives who works here? :
(striketrough the unnecessary)
Name :
I declare that the particular in these applications, are true in every respect. I understand that if any of the particulars supplied by me are
proved untrue, I am liable to be summarily dismissed. I am not willfully suppressed any meterial fact.
Jakarta, 30 NOVEMBER 2023
__________________________
Applicant’s Name and Signature
Page 3 of 3