HR05 - Employee Application Form - R03 - 181110 - RUDIAWAN
HR05 - Employee Application Form - R03 - 181110 - RUDIAWAN
HR05 - Employee Application Form - R03 - 181110 - RUDIAWAN
F/HR/05/R03
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Birth Date : P0CTOBER, 1ST, 1967 Birth City : BLORA Birth Country : INDONESIA
Information of Children (if applicable) AMALIA SARASWATI PUTRI First Name: Last Name: Birth Country: First Name: Last Name: Birth Country: First Name: Last Name: Birth Country: First Name: Last Name: Birth Country: Information of Parent & Siblings (if applicable) First Name Last Name HARMOYO Father Mother First Child Second Child Third Child Forth Child Fifth Child Sixth Child Parent's Contact #: Home Mobile Country Code Country Code 6 6 2 2 Area Code 296 Telephone 531286 Telephone SRI KADARWATI HERMAWAN RUDIAWAN TRIANI D. Birth City: Gender: Birth Date: Male Female INDONESIA Birth City: DEPOK INDONESIA ANDRAWINA RAHMADINA PRAMESWARI Gender: Male Female Birth City: DEPOK INDONESIA NADYA PARAMITHA PRAMESTI Gender: Male Female Birth City: JAKARTA Gender: Male Female
M/F M F M M F
Occupation
PERTAMINA BANK
APPLICATION OF EMPLOYMENT
(to be completed in BLOCK LETTERS and BLACK INK only)
F/HR/05/R03
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(Give all periods of employment up to present position, including SAS employment. Use additional sheet if necessary)
FACTORY MANAGER NEED NEW CHALENGE Rp. 500.000 ,Name RUDINANTO Title DIRECTOR Phone Country Code PT. REKAYASA INDUSTRI ENGINEERING, PROCUREMENT AND CONSTRUCTION KALIBATA, JAKARTA PIPING ENGINEER ENGINEERING WORK FORN PIPING PREPARE PIPING LAYOUT, ISOMETRIC, STRESS ANALYSIS, MTO DAN REQUISITION Area Code Telephone Start Date: NOV 1992 End Date: NOV 1996
Company Name: Business Type: Company Location: Position: Job Description & Responsibility:
PIPING DEPARTEMENT HEAD NEED NEW CHALNGE Rp. 1.300.000 ,Name TRI HARYO SUSILO Title DIRECTOR Phone Country Code PT. CEMARAB SIKO ENGINEERING ENGINEERING, PROCUREMENT AND CONSTRUCTION JAKARTA PROJECT ENGINEER PROJECT EXECTITION EXECUTE PROJECT IN TERMS OF TECHNICAL MATTER Area Code Telephone Start Date: NOV 1996 End Date: Feb-01
Company Name: Business Type: Company Location: Position: Job Description & Responsibility:
PROJECT MANAGER COMPANY GOING TO COLLAPSE Rp. 3.500.000 ,Name SUDJARWO Title PROJECT MANAGER Phone Country Code Area Code Telephone
APPLICATION OF EMPLOYMENT
(to be completed in BLOCK LETTERS and BLACK INK only)
F/HR/05/R03
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PIPING LEADER LOOKING FOR PROJECT MANAGEMENT JOB Rp. 6.500.000 Name HERU PRAMONO Title PIPING LEADER Phone Country Code PT. META EPSI ENGINEERING, PROCUREMENT AND CONSTRUCTION JAKARTA GENERAL MANAGER PROJECT MANAGEMENT MANAGE OIL & GAS PROJECT EXECUTION Area Code Telephone Start Date: Feb-02 End Date: NOV 2011
Company Name: Business Type: Company Location: Position: Job Description & Responsibility:
OPERATIONAL DIRECTOR SELF RETIRED Rp. 25.000.-000 ,Name SAID BADAR Title OPERATIONAL DIRECTOR Phone Country Code Area Code Telephone
Education Details (Starting from the highest qualification) BANDUNG INSTITUTE OF TECHNOLOGY College Name: Country: Degree Earned: Major: College Name: Country: Degree Earned: Major: College Name: Country: Degree Earned: Major: Language Ability
Language Native Read Write Speak
INDONESIA 1991 MECHANICAL ENGINEERING SMAN 1 YOGYAKARTA INDONESIA 1986 IPA SMPN 1 BLORA INDONESIA 1983 Year Earned: GPA: 980 Year Earned: 1983 GPA: Year Earned: GPA: 2.75
ENGLISH
High / Moderate / Low High / Moderate / Low High / Moderate / Low High / Moderate / Low High / Moderate / Low
High / Moderate / Low High / Moderate / Low High / Moderate / Low High / Moderate / Low High / Moderate / Low
High / Moderate / Low High / Moderate / Low High / Moderate / Low High / Moderate / Low High / Moderate / Low
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APPLICATION OF EMPLOYMENT
(to be completed in BLOCK LETTERS and BLACK INK only) Computer & Software Ability
Computer/Software Type Skill
F/HR/05/R03
High / Moderate / Low High / Moderate / Low High / Moderate / Low High / Moderate / Low High / Moderate / Low
Professional Training
Training Venue Period
AS ATTACHED ON MY CV
E-recruit / agency / write in / advertisement / employee referral / Others (Please specify) Yes No
Have you previously been employed in any SAS organization? If yes, please provide: Position: Country: Location: Reason for Leaving: Have you previously applied for employment with any SAS organization? If yes, please provide: Position applied: Result of your application:
Yes When:
No
Relative Working in SAS (Permanent or Contract or Temporary staff) (if applicable) (Relatives are defined as spouse, child, parent, brother/sister, uncle/aunt, nephew/niece, parents in-law, brother/sister in-law, son/daughter in-law) Do you have any relative working in SAS`group companies? IR. ENDRO SUYONO Name: Relationship: Department: Contact #: Name: Relationship: Department: Contact #: Name: Relationship: Department: Contact #: Phone Country Code Area Code Telephone Phone Country Code Area Code Telephone CLOSE FRIEND PROJECT MANAGER Phone Country Code Area Code Telephone Yes No
Do you have any outside business activities besides employment with SAS group companies? Company Name:
Yes
No
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APPLICATION OF EMPLOYMENT
(to be completed in BLOCK LETTERS and BLACK INK only) Have you ever been involved in any criminal activities (weapons, money laundering, drugs related, physical assults etc)? If yes, please explain: Have you ever been involved in a criminal lawsuit or in civil court? If yes, please explain: Have you ever been discharged / requested to resign from employment? If yes, please explain: Have you ever had issues related to banking / trading licenses before? If yes, please explain: Have you ever been addicted in drugs, alcohol or any other similar condition? If yes, please explain: Have you ever had a bad credit history with any banks, loan companies, and/or credit card companies? If yes, please explain: Are you holding an officer, director or executive power in an organization or firm? If yes, please explain: When will you be able to join us? Please state your expected salary: MAY, 1ST, 2013 USD 4500 Yes No Yes No Yes No Yes No Yes No Yes No
F/HR/05/R03
Yes
No
Consent Form CREDIT CHECK: I authorize SAS to conduct a background review of my credit information, such as credit history of past and pending loans, credit card accounts and other asset accounts and payment history as a condition of my being offered employment. I authorize the banking/lending institutions and card companies to provide information about my credit status. I hereby hold SAS and its officers, employees and authorized representatives, free and harmless against any loss, damage or liability arising from or as a result of the execution of this authority. BACKGROUND CHECK: I understand that I am being considered for a position (or have been offered employment) with SAS and its subsidiaries and affiliates ("the Corporation") that will allow me access to highly sensitive information concerning the Corporation's technology and systems. As a condition of my being considered for employment (or continuing my employment), I hereby consent to the Corporation's conducting a background information review of my employment experience. This review will include, but not limited to, a copy of my most recent performance evaluation, most recent security clearances (if applicable) and a discussion with my previous / current employer (s) concerning my professional qualifications, work performance, and ethical standards. I authorize the contacts listed on Employment Background section to provide the Corporation with any requested information about my previous employment. I hereby waive any claims against the Corporation and its current / former officer, directors, employees for performing the background information review. I understand the Corporation has a sole discretion to determine the eligibility for employment. PERSONAL DATA AUTHORIZATION I fully understand and accept that in the evaluation of my application and, if hired, for the duration of my employment, information regarding my personal circumstances, background, credit experience, service record and other employment data (collectively, "Personal Data") may be shared between and among the branches, subsidiaries and affiliates of SAS. I further understand and accept that SAS maintains computer systems in data centers and at other locations in Indonesia and that SAS and its affiliated companies may collect, store, process, disseminates or use my Personal Data in manner that causes it to be transferred or accessed from computer systems owned or operated by or on behalf of SAS or its affiliated companies throughout its computer network. By signing this form, I expressly manifest my consent to SAS' collection, storage, processing, dissemination or use of my Personal Data for all purposes relating to SAS' or its affiliated companies' administration of its human resources policies and programs. I hereby apply for employment in SAS. I certify that all statements made in this application, to the best of my knowledge, are true. I have not knowingly withheld any fact or circumstances, which would, if disclosed, affect my application unfavorably. I understand that any false information on this application will be sufficient cause for termination at any time if employed. I also authorize SAS to check/verify any information contained in this application. I accept that failure of consent to the credit check, background check and drug test will render me ineligible for employment.
Applicant's Signature: