JOB APPLICATION FORM
PERSONAL INFORMATION
Name : RIAN ANDRIAN
Place / Date of
: Indramayu / 2001-10-15
Birth
No Photo
ID Card Number : 3212221510010001
Address on ID : Jl. Pangeran Jayakarta No.15, RT.2/RW.05, Mekarmukti, Kec. Cikarang Utara, Kabupaten Bekasi,
Card Jawa Barat 17530 JAWA BARAT , Cikarang Utara
: Jalan Babakan Dampayang No. 40 RT 012/RW 007 Kelurahan Mekarjaya Kecamatan Gantar
Current Address
Kabupaten Indramayu 45264 JAWA BARAT , Indramayu
Mobile Phone
: 083172021028 Home Phone Number : 40
Number
Office Phone Email Address :
: Tidak Punya
Number rianadrian687@[Link]
Gender : Male Blood Type :B
Religion : Islam NPWP Number : 652716556347000
BPJS Kesehatan
: Tidak Punya BPJS Ketenagakerjaan Number : Tidak Punya
Number
Status : Single Nationality : Indonesia
Height : 160 cm Weight : 50 Kg
Sport / Hobbies : Sepak Bola
In case of
: UUS Phone Number : +6283165567179
emergency
who should we
Relationship : Ayah
contact?
FAMILY
Relationship Name Age Education Occupation Company/Institution
Other
Father Uus 52 Petani Bos
Degree
Other
Mother EULIS NURHAYATI 47 Ibu Rumah Tangga Ayah
Degree
FORMAL EDUCATION
Degree Name & Location of Institution Major GPA Period Graduated
SMK PGRI JATIBARANG , Jl. Mayor Dasuki No.159,
Senior High Senior High School Jan 2019 -
Jatibarang, Kec. Jatibarang, Kabupaten Indramayu, Jawa 84 Yes
School / Pemesinan Jun 2021
Barat 45273
NON FORMAL EDUCATION/TRAINING/COURSE/SEMINAR (Start with the most recent.)
Type of
Date / Period Certified
education/training/course/seminar
Form No: F-HR2-002 Rev. 2
ACADEMIC AND PROFESSIONAL ACTIVITIES AND ACHIEVEMENTS
Academic and professional activities, achievements, awards, publications, or
Date/Period
technical-professional communities. Indicate type or name
Pramuka Kosapparang 2021
PMR 2020
EMPLOYMENT HISTORY (Start with the most recent.)
PT DIPO TEKNIK PLUMBON
Jl. Nasional 5, Plumbon, Kec. Plumbon, Kabupaten Cirebon, Jawa Barat 45155
Name & Address of
Company/Institution
Period (Month/Year) Entry: 18 January 2021 Exit: Present
Entry Position: Operator Milling
Position
Last Position: Operator Produksi
Pembuatan kelakher dan As Roda
Major Roles & Duties
Salary (Net) Entry: 0 Last: 0
500.000
Other Benefits
Habis Kontrak Batas 4 Bulan
Reason of Leaving
REFERENCES(list of referees who know your academic or professional performance, not
family member)
Name Address Phone Number Relation
Tidak Punya Tidak Ada 08317201028 Tidak Ada
SKILLS
Language (not your native language):
Reading Writing Speaking
Language
Poor Fair Good Poor Fair Good Poor Fair Good
Bahasa Indonesia v v v
Computer Skills
Komputer dan Jaringan Internet
Mikroskop Word
Other Skills
Operator Milling
Operator Mesin Bubut
Komputer dan Jaringan
PREFERENCE OF PROFESSION
Accounting Finance Marketing
Sales Supply Chain MIS
Human Resources Production Engineering
R&D/QA Other :
PREFERENCE OF INDUSTRY
Manufacturing Financials Property
Natural Resources Retail & Trading Other :
SALARY EXPECTATION
IDR 4,000,000
ADDITIONAL INFORMATION
Have you ever applied to PT Gajah Tunggal Tbk before?
Yes
If yes, when? Dec 2023
Company: Pt bando
Do you have any special medical condition?
No
If yes, please explain:
Other companies outside PT Gajah Tunggal Tbk you are applying to:
List of friends or relatives now employed by PT Gajah Tunggal Tbk:
Name Position Relationship
ESSAY
Please think about yourself and answer these questions:
1. What is your goals in life?
2. Please mention your strength and weaknesses!
3. What do people think or say about you?
4. Other information that you would like to share which may be helpful in considering your qualifications and interests.
1. Pekerjaan
2. Kekuatan : di i siplin waktu kelemahan : kurang mahir dalam membaca alat ukur
3. saya orang yang berkerja keras
4. saya dapat mengoperasikan mesin produksi
PLEASE READ THIS STATEMENT CAREFULLY
I hereby confirm that the information given by me on this Job Application Form is accurate. I understand that any
falsification will be considered as a sufficient cause for dismissal. I authorize PT Gajah Tunggal Tbk to do a thorough
investigation in regards of this application concerning my personal information, education background, employment
history and any breach of rules.
________________________ _____/_____/________
Name & Signature Date
Thank you for taking time to complete this application