No.
F-PC-PMO-37-01032017-00
APPLICATION FORM
FOR INTERNAL USE :
Title Of Job :
Please take a few minute to fill out this application form and skills checklist. Provide your answers based on
your own working experience. This checklist is designed for a preliminary assessment to all proficiency
levels, from entry-level to senior level.
Personal Information
Full Name
Nationality
Sex
Place and Date Of Birth (dd-mm-yyyy)
Address
Marital Status
Religion
Languages
Address
City
Postal Code
State / Povince
Country
Private Email
Phone
Office Phone Number
Home (Fix Line Phone Number)
Emergency Number
Mobile (optional)
ID Card
NPWP
Indicate the URL / mailing list Harian Kompas / [Link]
of the advertisement you are [Link]
responding to. [Link]
[Link]
Mailing list…………………………………………………………………………..
Others (……………………………………………………………………)
Website URL or design sample [Link]
(mandatory for those applying [Link]
for Website Developers) [Link]
[Link]
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No. F-PC-PMO-37-01032017-00
Family Information
The Last Job
Relationship Name M/F Age Education Description
Position Company
Father
Mother
Brother/Sister 1*)
Brother/Sister 2*)
Brother/Sister 3*)
Brother/Sister 4*)
Brother/Sister 5*)
……………
Wife/Husband
Child 1
Child 2
Child 3
…………..
*)Including yoursel
Formal & Informal Education
Education Description
Level of Education
University’s Name
Majority
From (mmyy) to (mmyy)
City
GPA
Education Description
Level of Education
University’s Name
Majority
From (mmyy) to (mmyy)
City
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No. F-PC-PMO-37-01032017-00
GPA
Course / Training
Course / Training Organizer Place / City Year (mmyy)
- - - -
Social Activities
Organization Activity Title Year (mmyy)
Hobbies :
Describe your hobbies :
You read : The main when you read :
A lot
A few
A little
What you read usually ?
News paper :
Magazine :
Blog :
SUMMARY OF EXPERIENCE
-
Working Experience
From mm/yy Until mm/yy Company Title / Salary Reason To
Responsibility Leave
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No. F-PC-PMO-37-01032017-00
From mm/yy Until mm/yy Company Title / Salary Reason To
Responsibility Leave
IT Projects
Project Name
From (mm-yyyy) to (mm-yyyy)
Project Description
Company Name
Client’s Name
Platform
Database
Development Tools
Role
Description of your job assignment
Number of Team Members
Project Name
From (mm-yyyy) to (mm-yyyy)
Project Description
Company Name
Client’s Name
Platform
Database
Development Tools
Role
Description of your job assignment
Number of Team Members
Project Name
From (mm-yyyy) to (mm-yyyy)
Project Description
Company Name
Client’s Name
Platform
Database
Development Tools
Role
Description of your job assignment
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No. F-PC-PMO-37-01032017-00
Number of Team Members
You may add the above list by copying the table.
Skill Inventory
Please fill in the skill table below as our skill inventory information, you are not expected to have all the skills listed
here.
Indicate the skill proficiency using the following level:
0 = None 1= New Experience 2= Having basic skill 3= Having medium knowledge/skill
4= Having deep knowledge/skill 5= As expertise/Master
Language Skill :
You can add qualification rows to indicates your specific experience.
Spoken Level Written Level
Language
1 2 3 4 5 1 2 3 4 5
English
Mandarin
Indonesia
Technical Skills:
You can add qualification rows to indicate your specific experience.
# Skills Proficiency Level Years of Experience
Remark
1 JAVA (Back end, Web) 1 2 3 4 5 (in years)
a Spring
b servlet / web
c zkos
2 Front end / UI (Web dev) 1 2 3 4 5
a HTML 5
b CSS
c Ajax
3 Java Script (Web dev) 1 2 3 4 5
a React JS
b Angular JS
c Node JS
4 Database - SQL 1 2 3 4 5
a MYSQL
b Oracle
c Postgre
5 Database Admin 1 2 3 4 5
a Database Admin
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No. F-PC-PMO-37-01032017-00
6 TIBCO 1 2 3 4 5
a Tibco BW
b Tibco EMS
c Streambase
7 Oracle Middleware 1 2 3 4 5
a OSB
b SOA/BPEL
c BPM
8 Mobile 1 2 3 4 5
a Android native
b iOs / Swift
c Cordova (Hybrid)
9 PHP 1 2 3 4 5
a Laravel
b Cake PHP
c Codeigniter
d Wordpress
e Magento
10 OS Operating System 1 2 3 4 5
a Linux
b MS
c HP-UX
d Sun
11 Virtualization 1 2 3 4 5
a VW Ware
b Hyper v
c RHEV
12 Application Programming 1 2 3 4 5
a C/C++
13 Application Programming 1 2 3 4 5
a Internet Information Server (IIS)
Websphere Application Server
b (WAS)
c Java Web Server
d Apache Tomcat
e Netscape Enterprise Server
f JRUN
g Apache Hadoop
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No. F-PC-PMO-37-01032017-00
14 Siebel
a Configurator
b EAI
c EIM
d Siebel Instalasi
15 Technical Architecture/OS
a Windows Server
b Linux
c CCNA/Network
d Oracle Database
e HU UX
f Sun
16 Genesys
a Framework Installation
b Basic Networking
c Pure Engadge
d Pure Cloud
e DB-SQL
f VM / OS
g Telephony / PABX
17 IBM
a UNICA
18 Web Server
a Internet Information Server (IIS)
b Websphere Application Server
c (WAS)Web Server
Java
d Apache Tomcat
e Netscape Enterprise Server
f JRUN
g Apache Hadoop
19 Network
Network Protocol (TCP/IP,
a IPX/SPX, NetBEUI)
b Network Design
20 Methodologies
Object Oriented Programming
a (OOP)
Object Oriented Analysis and
b Design (OOAD)
c UML
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No. F-PC-PMO-37-01032017-00
21 Teradata
22 Cloudera
23 Oracle Cloud
24 [Link] Platform Cloud
25 Digital Marketing
a Mobile Apps (Ionic)
b Bootstrap
c SASS/Less
d Grunt, Gulp, Webpack
26 Design
a UI/UX Design
b Marketing Design
c Branding Design
27 Content
a Content Marketing (Hootsuite)
28 Salesforce
a Salesforce Cloud
b Admin
c Sales
d Social Studio
e Visual force
f Lightning
g Marketing
h Service
i Community
j Heroku
k API
l Einstein analytics
m HTML5
n Boothstrap
o CSS
p Java
Functional Skills:
You can add qualification rows to indicate your specific experience.
# Skills Proficiency Level Years of Experience
Remark
1 SDLC 1 2 3 4 5 (in years)
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No. F-PC-PMO-37-01032017-00
2 Requirement Document
3 Design Document
4 Test Plan
5 Business Process
a Use Cases
b UML
c Flow Chart
6 UI
a Wireframes
b Photoshop
7 Data Model
a ERD
b DFD
c Sequence Diagram
d PL/SQL
e Database Administration
8 Installation
9 Middleware
a Oracle Fusion Middleware
b TIBCO
c WebMethods
10 Industry
a Banking
b Telco
c Insurance
d Consumer Goods
e Finance
f Government
11 UPK
12 Documentation
13 testing
FOR HR PURPOSES
Question
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No. F-PC-PMO-37-01032017-00
The Question The Answer
Do you bind a contract with the company where you
work in this time?
Do you mind if we ask a reference to your company
where you have worked?
Do you have a part time job? Where and what is your
position?
Have you ever have a cronic disease, accident,
operation? When and what kind?
Are you willing to travel to other city?
What are you previous monthly salary and any facilities
that you get at present?
How much salary and other facilities do you expect?
When you can start to work?
Any additional notes / description:
I herewith confirm that all my above statements are true and fully responsible for all the consequences.
………………………………………,…………………………20……..
Color Photo
(…………………………………………………………………..)
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