Employee Application Form

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The following information will help us to assess your employment opportunity with éL Hotel Group (hereinafter called
the “Employer”). All portions of this application pertaining to you must be completed. We appreciate the time you
spend completing this application form.

Position applied for : Cost Control

Other position (s) you would like to be considered for : -
Salary Expectation : 4.5 Million Rupiah
Date Available to start :01 Februari 2026
PERSONAL DATA
Full Name : Dalih aditya Place / Date of Birth : 12 Juli 1993
Address : Jalan kerta dalem XIV no 1D, Sidekarye , Denpasar Bali
Religion : Moslem
City :Post Code :
Telephone (Handphone) :(Residence) : 081958208100
Telephone (Office) : -
I.D Card Number : - NPWP :
Marital Status : Married Hobby : Traveling
Height / Weight : 170/98 Blood Group : B
Distinguishing Marks : -
Email : adityadalih@[Link]

EDUCATION AND TRAINING

Name and address of school,
Major Course or
University or other training From Date To Date Degree of Certificate
Study
institution
Universitas Mataram 2012 2015 Tourism Yes

RECORD OF PREVIOUS EMPLOYMENT

1. Company Name : Tjendana Resort Management

Position : Receiving Clerk

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Period : From : Februari 2016 To Desember 2017
Address : Jln. Sunset Road 88x Seminyak , Badung Bali
Telephone :-
Nature of Business : Hospitality Supervisor’s Name : Made Suweca
Duties : Receiving all item that ordered by Purchasing then prepare all item that
property needed and inventory every end of the month
Last salary : Rp 2.500.000
Reason for leaving : Tryng to do Food and Beverage Bussines

2. Company Name : Radisson Blu Uluwatu Bali

Position : Receiving & Storekeeper
Period : From October 2018 To October 2019
Address : jln. Pemutih Labuan sait, Uluwatu Bali
Telephone :-
Nature of Business : Hospitality and Restaurant Supervisor’s Name : Ida Bagus Wiksudiana
Duties :
- Montior and Mantaine all store area to ensure clean and safety
- Receiving all item that ordered by Purchasing
- Maintain inventory records and stock levels
- Receive, store, and issue hotel supplies and materials
Last salary : Rp 3.300.000
Reason for leaving : Pandemi Corona Virus 2019

3. Company Name : Radisson Blu Uluwatu Bali

Position : Purchasing Officer
Period : From October 2019 To October 2020
Address : jln. Pemutih Labuan sait, Uluwatu Bali
Telephone :-
Nature of Business : Hospitality and Restaurant Supervisor’s Name : Wayan Eka Karya
Duties : Ordered All food and Beverage Request By All Departement ( only focus in
Food and Beverage request )
Last salary : Rp 3.300.000
Reason for leaving : Pandemi Corona Virus 2019
4. Company Name : PT. Cahaya Intan Medika
Position : Distribution Center
Period : From Juli 2021 To Juli 2022
Address : Jl. Hanoman I No.33, Sempidi, Kec. Mengwi, Kabupaten Badung,
Bali 80116
Telephone :-
Nature of Business : Medical Device Distributor Supervisor’s Name : Anang Kurnianto
Duties :

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- Prepare all orders from hospitals in Bali
- Ensure all items prepared by the driver team are correct and meet shipping
standards
- Ensure stock is always available in the warehouse
Conduct inventory at the end of each month to ensure all items are in line with
the system stock

Last salary : Rp 4.500.000

Reason for leaving : Caring for elderly parents at home
5. Company Name : Muda By Suka
Position : Cost Control
Period : From January 2023 To Vovember 2023
Address l. Munduk Catu No.9, Canggu, Kec. Kuta Utara, Kabupaten Badung,
Bali 80351
Telephone :-
Nature of Business : Restaurant and Bar Supervisor’s Name : Made Wira Adi Jaya
Duties : Ensuring the correctness of every transaction (especiallyspending/purchasing
transactions)
Organize and carry out the inventory process every month.
Inputting and checking the cost from the head chef
Make a daily flash cost report
Last salary : Rp 3.700.000
Reason for leaving : Move To Hotel Industrys

REFERENCES (Non – Relatives)

1. Name : Kholik Telephone Number : 0895624877747

Occupation : Cost Control Years known : 3 years
Address : Jimbaran Bali

2. Name : ________________ Telephone Number : __________________

Occupation : ________________ Years known : _______________________
Address : _______________________________________________________________

3. Name : ________________ Telephone Number : __________________

Occupation : ________________ Years known : _______________________
Address : _______________________________________________________________

LANGUAGE PROFICIENCY
Language Skill ( Language Spoken)
Language Speaking Reading Writing
Goo Goo Goo
English
d d d
Mandarin Poor Poor Poor

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Others Poor Poor Poor

FAMILY RECORD
Father’s Name : Dating Age : 70 years old ( RIP ) Occupation :
Mother’s Name : Kronyot Age : 68 Years Old Occupation : Famer
Permanent Address : Desa Ubug, kecamatan Jonggat
City : Praya Telephone : -

/ Wife’s Name:Renitha Ratu Hindistari Birth of Date : January 03, 1994 Occupation : Hotel Acoounting
Permanent Address : jalan kerta dalem no XIV . Sidekarye
___________________________ City : Denpasar Telephone : 082144124429
Children :
1. Name : _______________________ Birth of Date : _______ Male ______ Female _____
2. Name : _______________________ Birth of Date : _______ Male ______ Female _____
3. Name : _______________________ Birth of Date : _______ Male ______ Female _____

GENERAL INFORMATION

 Are you presently employed ? ______________ Yes √ No _________________________

Have you ever been discharged from employment ? If yes, Please explain NO

Have you any objection to our contacting your previous employers ? Yes √ No _______________

Have you had any serious illnesses, injuries or operations within the last (5) years? If so, please describe
: NO

Have you ever suffered from any of the following illnesses?

Tuberculosis Yes ___ No ___ √ Heart Disease Yes ___ No ___√
Hypertension Yes ___ No ___ √ Diabetes Yes ___ No ___√
Venereal Disease Yes ___ No ___ √ Epilepsy Yes ___ No ___√
Hepatitis Yes ___ No ___ √ HIV / AIDS Virus Yes ___ No ___√

Do you have any immediate family members, i.e. husband, wife, parents, child, brother, sister, working within the
company ? Yes ___ No √
If yes, who ?
(1) __________________________________________________________________________________________
(2) __________________________________________________________________________________________
(3) __________________________________________________________________________________________

DECLARATION

I certify that all statements made on this application are true and complete to the best of my knowledge. I
understand that misrepresentation or omission when discovered, will subject me to discharge and I hereby
authorize any investigation relating to my work experience, education or reputation for the purpose of my
application for employment.

Applicant’s Signature ________________________ Date December 22, 2025

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