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    Employee Application Form - Actual Synergy

    Uploaded by

    Patrico Rillah Setiawan
    This document is an employment application form containing fields for personal details such as name, address, date of birth, education history, employment history, languages spoken, and a declaration. The form requests information including the position applied for, expected salary, earliest start date, marital status, family, character references from past employers, bank account information, and health details. It states that any misrepresentation of facts could result in termination of employment.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd

    Employee Application Form - Actual Synergy

    Uploaded by

    Patrico Rillah Setiawan
    79 views2 pages
    This document is an employment application form containing fields for personal details such as name, address, date of birth, education history, employment history, languages spoken, and a declaration. The form requests information including the position applied for, expected salary, earliest start date, marital status, family, character references from past employers, bank account information, and health details. It states that any misrepresentation of facts could result in termination of employment.

    Original Title

    EMPLOYEE APPLICATION FORM_ACTUAL SYNERGY

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    © © All Rights Reserved

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    This document is an employment application form containing fields for personal details such as name, address, date of birth, education history, employment history, languages spoken, and a declaration. The form requests information including the position applied for, expected salary, earliest start date, marital status, family, character references from past employers, bank account information, and health details. It states that any misrepresentation of facts could result in termination of employment.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    79 views2 pages

    Employee Application Form - Actual Synergy

    Uploaded by

    Patrico Rillah Setiawan
    This document is an employment application form containing fields for personal details such as name, address, date of birth, education history, employment history, languages spoken, and a declaration. The form requests information including the position applied for, expected salary, earliest start date, marital status, family, character references from past employers, bank account information, and health details. It states that any misrepresentation of facts could result in termination of employment.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 2

    Code :

    EMPLOYMENT APPLICATION FORM

    POSITION APPLIED FOR SALARY EXPECTED EARLIEST COMMENCEMENT DATE

    1.

    2.

    PERSONAL PARTICULARS
    MALE
    FULL NAME HEIGHT WEIGHT
    FEMALE

    ADDRESS I.D. CARD NO. PHONE NUMBER OFFICE PHONE

    DATE OF BIRTH PLACE OF BIRTH NATIONALITY RELIGION TRIBE/DIALECT

    MARITAL STATUS : SINGLE MARRIED DIVORCED WIDOWED WIDOWER

    LINKEDIN ACCOUNT :

    FAMILY RECORD
    NAME RELATIONSHIP AGE OCCUPATION ADDRESS

    EDUCATION & TRAINING


    YEARS
    SCHOOL/COLLEGE/UNIVERSITY PROFESSIONAL HIGHEST STANDARD PASSED/
    INSTITUTE FROM TO CERTIFICATE/DIPLOMA/DEGREE

    CHARACTER REFERENCE
    NAME OCCUPATION/COMPANY ADDRESS/PHONE NO.

    EMPLOYMENT RECORD
    NAME OF FROM
    COMPANY TO POSITION SALARY REASON (S) FOR LEAVING

    BANK ACCOUNT
    PREVIOUS
    JAMSOSTEK
    NAME & ADRESS

    LANGUAGE/
    SPEAK SPEAK SPEAK WRITE WRITE WRITE  SHORTHAND : wpm
    DIALECTS
    WELL FAIR POOR WELL FAIR POOR
     TYPING : wpm
     TELEX, Experience……yrs……….mths.

     CALCULATER, Experience……yrs……mths
     SWITCH BOARD, Experience……yrs…….mtr
     OTHERS :

    OTHER INFORMATION

    DO YOU SUFFER FROM PHYSICAL DEFFECT OR HAVE YOU RECOVERED FROM SERIOUS ILLNESS YES NO
    IF YES PLEASE EXPLAIN:

    HAVE YOU EVER BEEN CONVICTED IN A COURT OF LAW? YES NO


    IF YES PLEASE EXPLAIN

    HAVE YOU EVER BEEN DISCHARGED FROM EMPLOYMENT? YES NO


    IF YES PLEASE EXPLAIN

    DECLARATION
    I declare that all information given by me are true and correct to the best of my knowledge
    I understand that any misrepresentation of facts will be sufficient cause for termination of employment without notice or payment lieu of notice.

    Date : Signature :

    Jalan Plawa No. 8 Seminyak Badung Bali

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