EMPLOYMENT APPLICATIO
IF YOU CAN, PLEASE COMPLETE IN ENGLISH Private &Confidential
Position Applied For：Housekeeping supervisor Second Choice：
PHOTO
Salary Expected：basic your standar company Available Date：
Name：Hermawan susanto Blood Group : O
Citizenship：Indonesia Telephone No.：087860974067
KTP / SIM No.：5202020104940002 BPJS Ketenagakerjaan No : 23135498311
NPWP No.：81.358.597.3-915.000 Mobile phone No.：
E-Mail：[email protected] Home Address (KTP)：desa labulia kecamatan jonggat kab lombok tengah NTB
Present Address：jln raya semer gng tunjung mekar no 9 banjar peliatan kerobokan badung
Age Place / Date of Birth Sex Height Religion Social Status Marital Status
29 01 april 1994 Man 164 muslime □Single □Married
Date of Place of work
FAMILY Name Phone No.
Birth /Age
Father Rusalan
Mother Soleha
ida yuli
Husband /Wife kusuamaningru 26 085739063662
m
Spouse
Child 1
Child 2
Child 3
Child 4
Emergency Contact Relationship Address Phone No.
ida yuli wife kerobokan badung 085739063662
EDUCATION RECORD
Name of school Years attended
EDUCATION Certificate Obtained
From To
Professional Training Sdn 1 labulia lombok teangah 2002$ 2008
smp/mtsn 1 kuripan lombok
University 2008 2010
barat
Sma/ma hidayatul lombok
Secondary School 2010 2012
tengah
Other Studies sertifikat uji kompetensi 2017 2018
SPECIAL SKILLS
first aid, fire figthing, driving,
COMPUTER (please specify which software),
SHORTHAND, LIFEGUARD, FIRST AID,
electrical, boilerman,
FIRE FIGHTING, DRIVING, ELECTRICAL,
BOILERMAN, MASSAGE, etc. And other
brushing
professional task certificates.
LANGUAGES
SPOKEN WRITTEN
Please mark the appropriate boxes ABOVE ABOVE
FLUENT FAIR POOR FLUENT FAIR POOR
AVERAGE AVERAGE
MANDARIN
CANTONESE
ENGLISH
JAPANESE
Fair Fair
OTHERS
Please specify 请具体写出:
EMPLOYMENT RECORD
LIST PRESENT JOB FIRST
From To
Name and Address of Basic Monthly Service Charge
Month Month Position Held Reason for Leaving
Employer Salary
Year year
14
13 marvh Dw linen & room
Novotel nusaa dua bali Septembe 1.400.000
2014 attendent
r 2012
10 april 5 august
Amaterra villa & spa Dw room attendent 2600.000
2014 2015
Staff room
7
Dash hotel seminyak 20 april attendent &
Septembe 2700.000-3.500.000
bali 2021 housekeeping
r 2015
supervisor
10
15 august supervisor public
Restoran kingsway bali october 3.500.000
2023 area
2021
PLEASE LIST FORMER EMPLOYERS/SUPERIORS
NAME COMPANY OCCUPATION Phone No. Address
pak chef excecutive 081259007
buk saka housekeeper 0812391811
RELATIVES OR FRIENDS WORKING IN THIS HOTEL OR OWNING COMPANY
NAME POSITION COMPANY RELATIONSHIP
OTHER INFORMATION
YES NO IF SO, STATE NATURE
because I want to find new
no
1. Have You Ever Been Dismissed From Any Employment Because Of
experiences and increase my abilities
Misconduct?
to any extent
no
2. Have You Contributed To The Pension Fund And Medical Insurance
Fund?
3. Have You Contributed To The Housing Fund?
no
HEALTH
I am on long-term medication / treatment for because I am
How Is Your Health? GOOD FAIR
not in pain
DECLARATION
I Certify that to the best of my knowledge, the foregoing statements and medical history information given by me are true. I understand that if I am
employed, any misrepresentation or omission by me herein will be sufficient cause for dismissal from the service of xxx hotel. I also authorize any
investigation of the above information for purposes of verification. Any payment made by the Company during absence due to sickness or accident is
at the discretion of the Company, and not a legal liability. I consent to taking any pre-employment physical examination required by the Company
and such future physical examinations as may be required by the Company.
Hermawan susanto APPLICANT’S SIGNATURE
DATE 3 february 2024
Note: This application does not mean an offer employment
FOR OFFICE USE ONLY
INTERVIEW
CODE A =EXCELLENT B =GOOD C =FAIR D =POOR
COMMENTS
CODE REMARKS CODE REMARKS CODE REMARKS
APPEARANCE
PERSONALITY
ATTITUDE
COURTESY
JOB KNOWLEDGE
INITIATIVE
CONFIDENCE
LANGUAGE
□ RECOMMENDED □ RECOMMENDED □ RECOMMENDED
INTERVIEWER’S
□ PENDING □ PENDING □ PENDING
SIGNATURE
□ REJECTED □ REJECTED □ REJECTED
st ND
1 INTERVIEW BY_______________ 2 INTERVIEW BY_______________ 3RD INTERVIEW BY _______________
REFERENCE CHECKS (
Strictly Confidential) By : Date:
ACCEPTANCE
Department : Section :
Job Title : Job Grade：
Salary on Probation : Salary on Confirmation :
Commencement Date : Division/Department Head :
HRD / HRM : Resident Manager :
Deputy General Manager : General Manager:
Remarks :
Staff No. : Locker No.:
Health Certificate No. ： Banking Account No.
