/ YAYASAN RUMAH ENERGI
APPLICATION FORM / Do not write in this space
Position Applied For / INSTRUCTIONS
Please answer each question clearly and completely. Type or print in ink. Read carefully and follow all directions.
  1. Family Name

  1. First Name

  1. Present Nationality

  1. Address
/ Permanent / Phone
Present / Phone
Email
  1. Employment Record Starting with your present post, list in reverse order every employment you have had. Use a separate block for each post. Include also service in the armed forces and note any period during which you were not gainfully employed. If you need more space, attach additional pages of the same size. Give net salaries per month for your last or present post.

Title of your post / Start date / End date
Name of employer / Salaries per month (IDR)
Address of employer / Other Monetary Benefits
Other Non-Monetary Benefits
Name of supervisor
Main responsibilities
Reason for leaving
Title of your post / Start date / End date
Name of employer / Salaries per month (IDR)
Address of employer / Other Monetary Benefits
Other Non-Monetary Benefits
Name of supervisor
Main responsibilities
Reason for leaving
Title of your post / Start date / End date
Name of employer / Salaries per month (IDR)
Address of employer / Other Monetary Benefits
Other Non-Monetary Benefits
Name of supervisor
Main responsibilities
Reason for leaving
Title of your post / Start date / End date
Name of employer / Salaries per month (IDR)
Address of employer / Other Monetary Benefits
Other Non-Monetary Benefits
Name of supervisor
Main responsibilities
Reason for leaving
  1. Preferred field to work

  1. Expected monthly compensation

  1. Availability / Notice Period Required

  1. Would you accept employment for less than six months?
/ Yes / No
  1. If you are disabled, please state whether you require any adjustments to be made to facilitate your participation in the selection process.Human Resources will contact you to discuss at a later date.
/ Yes / No
  1. Have you previously submitted an application for employment with YRE?
If the answer is “yes”, when and for what position(s)? / Yes / No
  1. Knowledge of languages
/ Mother language
Other languages / Read / Write / Speak / Understand
Easily / Not Easily / Easily / Not Easily / Easily / Not Easily / Easily / Not Easily
  1. Educational (University or equivalent, please do not translate or equate to other degrees)

Name, Place and Country / Attended (Month/Year) / Degrees / Main Course of Study
From / To
  1. Other formal training or education

Name, Place and Country / Attended (Month/Year) / Type / Certificates
From / To
  1. Have you any objections to our making inquiries of your present employer?
/ Yes / No
  1. References List three persons, not related to you, who are familiar with your character and qualifications.

Full Name / Full Address / Business or occupation
  1. Have your ever been arrested, indicted, or summoned into court as a defendant in a criminal proceeding, or convicted, fined or imprisoned for the violation of any law (excluding minor traffic violations)? If “yes”, give full particulars of each case in an attached statement.
/ Yes / No
I certify that the statements made by me in answer to the foregoing questions are true, complete and correct to the best of my knowledge and belief. I understand that any misrepresentation or material omission made on a Personal History form or other document requested by the Organization renders a staff member of the YayasanRumahEnergi liable to termination or dismissal.
Date: / Signature:

Application Form – YayasanRumahEnergiPage 1 of 2