FORMULIR PENERIMAAN KARYAWAN

Jabatan / Bidang Pekerjaan : :..............................................................................................................

Gaji Sekarang : ...........................................
.........................Gaji Yang Diminta : .........................................................Pas Foto
Tanggal Masuk Kerja : :..............................................................................................................

DATA PRIBADI

Nama Lengkap : ...................................................................................................................................

Alamat Tempat Tinggal : ...................................................................................................................................
No Telp (Tempat Tinggal) : ...................................................................................................................................
Tempat , Tanggal Lahir : ...................................................................................................................................
Jenis Kelamin : ...................................................................................................................................
Status : ...................................................................................................................................
Warga Negara : ...................................................................................................................................
Suku / Dialek : ...................................................................................................................................
No. KTP : ...................................................................................................................................
Aktivitas Sosial / Hobi : ...................................................................................................................................
Nama Istri / Suami : ...................................................................................................................................
Alamat Pekerjaan : ...................................................................................................................................
Jumlah Anak & Umur : ...................................................................................................................................

DATA KEAHLIAN DAN PELATIHAN

Bahasa Yang Dikuasai : ...................................................................................................................................

Keterampilan : ...................................................................................................................................
Keahlian Lainnya : ...................................................................................................................................
Mengetik : ...................................................................................................................................
Sertifikat yang dimiliki 1..1 ..............................................................................................................

2 ..............................................................................................................

Peralatan Kantor yang dikuasai 1..1 ..............................................................................................................

2.2 ..............................................................................................................

Latihan yang pernah diikuti 1..1 ..............................................................................................................

2.2 ..............................................................................................................
 DAFTAR INTERVIEW

Nama Lengkap : .......................................................................................................................

Nama Panggilan : .......................................................................................................................
Tempat , Tanggal Lahir : .......................................................................................................................
Agama : .......................................................................................................................
Jenis Kelamin : .......................................................................................................................
Alamat Tempat Tinggal : .......................................................................................................................
Nama Ayah : .......................................................................................................................
Pekerjaan Ayah : .......................................................................................................................
Nama Ibu : .......................................................................................................................
Pekerjaan Ibu : .......................................................................................................................
Alamat Orang Tua : .......................................................................................................................
Jumlah Saudara : .......................................................................................................................

1. Nama : ............................................ 2. Nama : .........................................

Alamat : ............................................ Alamat : .........................................

3. Nama : ............................................ 4. Nama : .........................................

Alamat : ............................................ Alamat : .........................................

5. Nama : ............................................ 6. Nama : .........................................

Alamat : ............................................ Alamat : .........................................

Berdomisili di Batam Sejak : .......................................................................................................

Pernah berurusan dengan polisi : .......................................................................................................
Motivasi Keja : .......................................................................................................
Pengalaman Kerja 1. .....................................................................................................
2. .....................................................................................................
3. .....................................................................................................
Penanggung Jawab Kerja : .......................................................................................................

Batam , ........................................

Pelamar, Yang Menginterview, Disetujui,

( ) ( ) ( )
 Dari Sampai Gaji Jabatan
Bln / Thn Bln /Thn Pertama Terakhir

Nama dan Alamat Kerja Nama Atasan

Nama Bawahan

Alasan Berhenti :
Uraian Pekerjaan :

Dari Sampai Gaji Jabatan

Bln / Thn Bln / Thn Pertama Terakhir

Nama dan Alamat Kerja Nama Atasan

Nama Bawahan

Alasan Berhenti :
Uraian Pekerjaan :

LAIN-LAIN
a. Apakah saudara mempunyai family dalam perusahaan ini,
jika ada harap tulis nama dan jabatannya

Nama : ................................. Dept : ...............................

b. Apakah saudara mengenal seseorang dalam perusahaan ini,

jika ada harap tulis nama dan jabatannya

Nama : ................................. Dept : ...............................

PERNYATAAN :
Saya menyatakan bahwa informasi yang saya berikan ini adalah benar dan
tepat. Jika informasi yang saya berikan tidak benar saya bersedia di-PHK.

Batam ......................

Pelamar, Personalia,

(..............................) (..............................)