This document is a form collecting personal and employment information for a job applicant. It requests information such as the applicant's name, address, religion, family, education history, and previous work experience. The form collects details like the names and dates of birth of family members, the schools attended and degrees earned, as well as the companies worked for, positions held, and reasons for leaving previous jobs.

1. PT.KARUNIA ADI SENTOSAFORMULIR DATA KARYAWAN
DATA PRIBADI
Nama ........................................... Jenis Kelamin ...........................................
Alamat ........................................... Agama ...........................................
........................................... Status ...........................................
RT / RW ........................................... Hobby ...........................................
Kota/Kode Pos ........................................... Tinggi Badan ...........................................
Telepon ........................................... Berat Badan ...........................................
No KTP ...........................................
DATA KELUARGA
STATUS NAMA L/P TEMPAT / TGL LAHIR PEKERJAAN
Ayah Kandung
Ibu Kandung
Istri / Suami
Anak Ke 1
Anak Ke 2
Anak Ke 3
RIWAYAT PENDIDIKAN
FORMAL NAMA SEKOLAH KOTA JURUSAN IJAZAH KETERANGAN
SD
SMP
SMU / SMK
UNIV
NON FORMAL NAMA SEKOLAH KOTA JURUSAN IJAZAH KETERANGAN
1.

2. 2.
3.
Lain Lain
RIWAYAT PEKERJAAN
NAMA PERUSAHAAN LOKASI PEKERJAAN JABATAN GAJI ALASAN BERHENTI
...................., .......................
hormat saya
(..........................................)