8/19/2019 WSE JobApplication Form (1)

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Application Form

 Name I.C. No.

Home Address

Sex:

Do you live in : Own House [ ] Tel. No. (Off)

Rented House [ ] (Res)With Parents [ ] (H/P)

Others [ ]-------------------------- (E-mail)

Date of Birth : Place of Birth: Working Starting Date:

Marital Status : Nationality: Race: Religion:

Driving License : Do you own a car : Yes No

EDUCATION & PROFESSIONAL QUALIFICATIONFROM –  TO

(STATE DATE)  NAME OF SCHOOL, COLLEGE STATE LEVEL ATTAINED MAJOR COURSE OR SUBJECT

MEMBERSHIP OF PROFESSIONAL & OTHER SOCIETIES (state dates and posit ion held)

Yes No  Type:

Program/Languages:

Position applied for:

Are you interested in any other position:

Current Salary : Salary Expected:

Details of current remuneration package:

When are you available for work: Notice Period:

PHOTO

Computer proficient

AJ

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EMPLOYEMENT HISTORY(Commence with curr ent or l ast employment)  

Date of Employment Date Employment Ended:

 Name of Employer:

Address of Employer:

State nature of employer’s business: 

Position Held:

 Name & designation of immediate supervisor:

Total number of employees in company: Number of staff supervised by you:

Give detailed description of duties/responsibilities:

How did you get employed in this company(Through Advertisement, Recommendation, etc.)

Reason for Leaving:

Last Drawn Salary:

Date of Employment Date Employment Ended:

 Name of Employer:

Address of Employer:

State nature of employer’s business: 

Position Held:

 Name & designation of immediate supervisor:

Total number of employees in company: Number of staff supervised by you:

Give detailed description of duties/responsibilities:

How did you get employed in this company

(Through Advertisement, Recommendation, etc.)

Reason for Leaving:

Last Drawn Salary:

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Date of Employment Date Employment Ended:

 Name of Employer:

Address of Employer:

State nature of employer’s business: 

Position Held:

 Name & designation of immediate supervisor:

Total number of employees in company: Number of staff supervised by you:

Give detailed description of duties/responsibilities:

How did you get employed in this company(Through Advertisement, Recommendation, etc.)

Reason for Leaving:

Last Drawn Salary:

Date of Employment Date Employment Ended:

 Name of Employer:

Address of Employer:

State nature of employer’s business: 

Position Held:

 Name & designation of immediate supervisor:

Total number of employees in company: Number of staff supervised by you:

Give detailed description of duties/responsibilities:

How did you get employed in this company

(Through Advertisement, Recommendation, etc.)

Reason for Leaving:

Last Drawn Salary:

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FAMILY DETAILS

RELATIONSHIP NAME AGE ADDRESSOCCUPATION

PRESENT/PAST NAME OFEMPLOYER

Father

Mother

Brother/Sister

Spouse

Children

MEDICAL DETAILS

Are you in good health? Yes  No If no, why?Please state with dates, any serious illness, allergies, operations, disabilities or accidents, you had.

Have you been refused insurance coverage? Yes No 

Do you take alcohol/drugs? Yes No To what extent?

Have you ever been convicted in a court of law? Yes No If so, give details:

Are you involved in any administrative, civil or criminal case?

Are you in debt? Yes No 

If so, to whom, to what extent & for what reason?Have you been dismissed or suspended from any position? Yes No 

If so, state details:

Are you interested or engaged in any business? Yes No

What type of Business?

Do you have any other sources of income? Yes No (Please specify) 

LANGUAGES INDONESIA ENGLISH CHINESE (SPECIFY)   ………... …….….. …………

SPOKEN ( ) ( ) ( ) ( ) ( ) ( )

WRITTEN ( ) ( ) ( ) ( ) ( ) ( )

(please specify with scale 1-10, 10 is the highest score)

Hobbies, game & other interests

ADDITIONAL INFORMATION  –   Give any additional information which you consider may be of interest to a prospective employer, if possible state why you believe you are suitable for the position you are applying

ORGANISATION CHART OF COMPANY MOST RELEVANT TO POSITION APPLIED FOR.

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(PREVIOUS OR CURRENT EMPLOYER) State company’s name, indicate where you fit in within the organization.

EMPLOYEMENT REFERENCESFrom past and present employment

 Name: Name :

Position: Position:

Company Name: Company Name:

Company Address: Company Address:

Tel: (Office) (Res) Tel: (Office) (Res)

PERSONAL REFERENCESGive names or person of responsibi li ty who have known you f or at least 3 years

 Name: Name :

Position: Position:

Company Name: Company Name:

Company Address: Company Address:

Tel: (Office) (Res) Tel: (Office) (Res)

Years of Acquaintance Years of Acquaintance

Name of companies with which you have pending application for employment.

(Give dates of application) 1.

2.

3.

Have you applied with this office before? Yes No State Date:

I HEREBY CONFIRM ALL THE ABOVE DETAILS TO BE TRUE AND CORRECT. I AUTHORIZE WALL STREET ENGLISH INDONESIA TO CARRY OUTREFERENCE CHECKS WITH PAST EMPLOYERS AND REFEREES IN CONNECTION WITH THIS APPLICATION.I UNDERSTAND THAT ANY MISREPRESENTATION OR OMISSION OF INFORMATION WILL BE SUFFICIENT REASON FOR WITHDRAWAL OF AN OFFEROR SUBSEQUENT DISMISSAL, IF EMPLOYED.

 Date Signature: