PERSONAL DATA
 Full Name  
 Sex  
 Address (In Jakarta)   
 Phone Number  
 Home Address   
 Residence Phone  
 Citizenship  
 ID Card Number  
 Issued at (City)  
 Validity  
 Place & Date of Birth  
 Religion  
 Marital Status  
 Number of Children  
 Blood Type  
 Health Condition  
 Mental Condition  
 Expected Monthly Gross Salary  
 I can commence to work
 (Answer: # of days after confirmation, immediate)
 
 Please treat the above information as  
 Your Picture   
   

FAMILY DETAILS
(*Answer: If Married: Husband/Wife/Son/Dougther, If Single: Father/Mother/Brother/Sister)
 Name
 Date of Birth
 Occupation
 Relationship*


EDUCATION(S) RECORDS
(Formal Education)
School Name - Place (city)
Faculty / Majoring
From (year)
To (year)
IP (GPA) / Rank

(Informal Education)
School Name - Place (city)
Subject
From (mm/yy)
To (mm/yy)
Predicate

(Extra Curricular)
Extra Curricular Subject
Activities
From (mm/yy)
To (mm/yy)
Notes


WORKING EXPERIENCE(S)
Company
Job Title
From (year)
To (year)
Last Salary

WORKING EXPERIENCE(S) (continued - fill per associated item above)
Job Descriptions
Reason To Leave


ENGLISH LANGUAGE
Written English
Reading technical literatures/manuals/brochures/reports etc.
Writing technical proposals/descriptions/reports etc.
Reading business correspondences
Writing business correspondences
My written English in general is

Verbal English
Day to day conversations
Understanding native speakers
Telephone conversations
Presentations or public speaking
In general my verbal English is


PERSONAL COMPUTER APPLICATION(S) KNOWLEDGE AND EXPERIENCE
Type
Program Name / Version
Application / Projects
Period Used


PREFERENCES
I preferably work 
I preferably work 
I am willing to travel 
I am willing to work 
In order to achieve the Completion of my work 
Do you have computer at home 
If yes, will you complete your work at home? 

I herewith certify that I honestly answer all questions above, and guarantee that the information are true and correct. I am taking my responsibility if the above are incorrect.





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