Candidate Application Form V2 23 June 2015 Neo Eltari

Employee Application Form
The following information will help us to assess your employment opportunity with Archipelago International
(hereinafter called the Employer). All portions of this application pertaining to you must be completed. We
appreciate the time you spend completing this application form.
Position applied :
Recent
____________________________________________
Second position applied :
Photo
____________________________________________
Salary Range Expectation :
____________________________________________
Notice Period : ____________________________________________
PERSONAL DATA
Full Name : Date of Birth :
Address :
City : Post Code :
Telephone (H) :
Telephone (M) :
Skype ID :
Email Address :
Facebook / Twitter :
Linkedin :
I.D Card Number : Date of Expiry :
Marital Status : Religion :
Height / Weight : Blood Group :
EDUCATION AND TRAINING
Name and address of school,

Major Course or Decree of
University or other training From Date To Date
Study Certificate
institution
HR/Application Form/002 Page 1

RECORD OF PREVIOUS EMPLOYMENTS

1. Company Name : ______________________________________________________
Position : _____________________________________________________
Period : From ___________________ to __________________________
Address : ______________________________________________________
Telephone : ______________________________________________________
Nature of Business : ______________________________________________________
Supervisors Name : ______________________________________________________
Duties : ______________________________________________________
Last salary : Rp ___________________________________________________
Reason for leaving : ______________________________________________________
2. Company Name : ______________________________________________________

Position : ______________________________________________________
Period : From ___________________ to __________________________
Address : ______________________________________________________
Telephone : ______________________________________________________
Duties : ______________________________________________________
Last salary : Rp ___________________________________________________
3. Company Name : ______________________________________________________

Position : ______________________________________________________
Period : From ___________________ to __________________________
Address : ______________________________________________________
Telephone : ______________________________________________________
Duties : ______________________________________________________
Last salary : Rp ___________________________________________________
REFERENCES (Non Relatives)

1. Name : ___________________ Mobile Number : _____________________
Occupation : ___________________ Years known : _____________________
Address / Email : ____________________________________________________________

Address / Email : ____________________________________________________________


Address / Email : ____________________________________________________________

Address / Email : ____________________________________________________________
LANGUAGE PROFICIENCY (Language Spoken)
Speaking Reading Writing
Language
Poor Good Excellent Poor Good Excellent Poor Good Excellent
English
Mandarin
..
..
FAMILY RECORD
Fathers Name : __________________ Age: _______ Occupation : ___________________________
Mothers Name : __________________ Age: _______ Occupation : ___________________________
Permanent Address : ____________________________________________ City: __________________
Telephone : __________________________________________________________________
Husband / Wifes Name : ___________________Date of Birth: __________Occupation:_________________
Children:
1. Name : _______________________ Date of Birth : ________Male _______Female __________
GENERAL INFORMATION
Are you presently employed? _______________________Yes ______________No ___________________
Have you ever been discharged from employment? If yes, Please explain ___________________________
Can we contact your present employer for a reference? _______________________Yes ______ No _____
Have you ever suffered from any of the following illnesses

ILLNESSES Yes No ILLNESSES Yes No
Tuberculosis Hepatitis
Heart Disease HIV / AIDS
Hypertension Venereal Disease
Diabetes Serious Illnesses
Epilepsy Injuries or Operations in last 5 Years
Do you have any immediate family members (i.e. husband, wife, parents, child, brother, sister) working with
any of Archipelago Hotels? Yes ______ No______ If yes, who and which unit?
(1) ____________________________________________________________________________________
(2) ____________________________________________________________________________________
(3) ____________________________________________________________________________________
DECLARATION
I certify that all statements made on this application are true and complete to the best of my knowledge. I
understand that misrepresentation or omission when discovered, will subject me to discharge and I hereby
authorize any investigation relating to my work experience, education or reputation for the purpose of my
application for employment.

Applicants Signature ___________________________ Date _________________________________

Candidate Application Form V2 23 June 2015 Neo Eltari

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Employee Application Form

Full Name : Date of Birth :

City : Post Code :

I.D Card Number : Date of Expiry :

Marital Status : Religion :

Height / Weight : Blood Group :

EDUCATION AND TRAINING

Name and address of school,

HR/Application Form/002 Page 1

RECORD OF PREVIOUS EMPLOYMENTS

2. Company Name : ______________________________________________________

3. Company Name : ______________________________________________________

REFERENCES (Non Relatives)

2. Name : ___________________ Mobile Number : _____________________

3. Name : ___________________ Mobile Number : _____________________

HR/Application Form/002 Page 2

Address / Email : ____________________________________________________________

4. Name : ___________________ Mobile Number : _____________________

Have you ever suffered from any of the following illnesses

HR/Application Form/002 Page 3

Applicants Signature ___________________________ Date _________________________________

HR/Application Form/002 Page 4

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Applicants Signature _ Date _______