APPLICATION FORM

AAA/2017/19/138

PERSONAL DETAILS
Full Name
*
Sex
 *
Place, Date of Birth
   *
Religion
*
Nationality
Ethnic
Martial Status
*
   
CURRENT MAILLNG ADDRESS
PERMANENT MAILLNG ADDRESS
Telp. No. (Off)
(Res)
Telp. No. (Off)
(Res)
(H/P) *Fax. (H/P) Fax.
Email : * Email :
Driver License A/No.
Do you own a car :
 
   
FAMILY AND ASSOCIATION DETAILS
Relationship Name Age Last Education Occupation
Father *
Mother *
Husband/Wife
Child
Brothers/Sister
   
Is there any family or relatives working for PT Lion Group? If yes, please give details in table below:
RELATIONSHIP NAME UNIT/DEPARTMENT AREA/DISTRICT
   
EDUCATIONAL BACKGROUND
From - To Schools, Collage, Universities Major GPA Diploma
(Yes/No)
   
SEMINAR/COURSE/WORKSHOP
From - To
(States dates)
Topic Organizer & Location Certificate
(Yes/No)
   
WORKING EXPERIENCE

* Please state in chronolical order of your work experience beginning with the latest or
present employment.
 
Start Date - End Date Company Job Category
 
EMPLOYMENT RECORD

Date of Employment:

Date Employment Ended:
Company Name
Address
Business Line
Current/Latest Position
Report directly
(Name/Position)
/
Number of Sub-Ordinates
person(s)
Main Job Responsibilty
Achievement
How did you get emplyoed
Reason for leaving
Last Drawm Salary
 
ADDITIONAL INFORMATION
 
SPECIAL ACTIVITIES
From - To Name of Organization Place Position
 
SKILLS (Languages, Technical, Computer, etc)
TYPE OF SKILLS LEVEL OF PROFICIENCY
 
OTHER PERSONAL INFORMATION
What are you doing in your leisure time?
How often do you read?
What is your point of interest?  
Have you ever been charged or convicted of any criminal offence?
Do you have any objections to a criminal record check being conducted?  
Have you been dismissed or suspended from any position?  
If so, state details:
Have you ever suffered from any serious medical condition eg. tuberculosis, diabetes, asthma or epilepsy?  
If YES, please explain the condition:  
Have you ever experienced any physical or emitional illness which may impair your work performance?  
If YES, what is the nature of your illness?  
Do you have any special medical needs?  
If YES, what is the nature of this requiremenet?  
 
REFERENCES
NAME POSITION COMPANY ADDRESS/PHONE
 
ATTACHMENT
EDUCATIONAL BACKGROUND
Subjects Average value Total
CLASS X CLASS XI CLASS XII
Mathematics
Physics
Recently GPA

: Recently GPA
: Recently GPA

CHECKLIST COMPLETED APPLICATION FORM

  Application Letter (In Hand Writing & Stamped)
  Statement Form
  Curriculum Vitae
  [Copy] Legalized of Grade Report Cards and Transcripts Grade
  [Copy] TOEFL (With Minimum Score 475)
  [Copy] Family and ID card
  [Original] Legalized of Police Notes (SKCK)
  [Original] Drug-Free Original Certificate
  [Original] Unmarried Original Certificate
  [Original] Original Certificate of No Color Blind Eye
  2 (two) pieces 4X6 recent photograph
  Postcard size, color photos of the whole body/3R
 
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