Job Application Form
Photo Please fill in the form completely
Position Applied Position Hired
For : For :
Date of Interview : First Day or Work :
A: Personal Data
Full Name : Gender : F/M
Place of Birth : Date of Birth :
Nationality : Religion :
Home Address :
Phone / Hp :
Language / Skills
English Spoken ( Poor / Fair / Good ) Written ( Poor / Fair / Good )
Mandarin Spoken ( Poor / Fair / Good ) Written ( Poor / Fair / Good )
Other Language (s) : please state,
Other Skills ? Please state :
B : Family
Status : Single / Married / Divorce
Husband / Wife Name :
Date of Birth : / / Religion :
Occupation :
Child :
(Parents, Siblings including yourself)
Name M/F Date of Birth Occupation Name of Company
Father
Mother
1st Child
2nd Child
3rd Child
C : Education / Training Background
School Qualifications Year (Period)
D : Working Experience
Name of Company Year Position Last Salary Reasons to Leave
Expected Salary :
E : References
Name Contact No Relationship Company / Position
F : Do you have any relatives working in this school? Yes / No
Name Position Relationship
G : In any case of emergency (preferably not staying in the same house)
Name Contact No Relationship
H : Medical ( Personal Health )
1. Do you have any history of serious illness? Yes No
If yes, pls describe : ___________________________________________________________________________
2. Do you currently have any sickness / illness? Yes No
If yes, pls describe : ___________________________________________________________________________
I certify that all information in this application form are true and accurate.
(Name & Signature)
Jakarta, / /
Office use only
Kindly write down your values about children and how can you contribute to their learnings. (Minimum 150 words)
Please write down your long term goals. What do you see yourself in 3 years time. (Minimum 100 words)
What do you think your strength is that can contribute to the school? (Examples: good in creativity/performing on stage/story telling
& etc)
Accepted / Rejected (comments)
Principal’s notes: