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CANDIDATE INTERVIEW FORM
1. Date 2. Position Applied
I PERSONAL INFORMATION AND PREFERENCES
3. Full Name Oktavian Tegar Pambudi
4. Date and Place of birth 19 Oktober 1997
5. Sex Male Female
6. Marital Status (if single skip to
Single Married Divorce
number 8)
7. Number of children 1
8. Main Mode of Transportation Public Transport Car Motorbike Others
9. Home Address Jl. Merapi RT 07 RW 02 No 80b Ds. Bambe Kec Driyorejo , Gresik
10. Phone Number Home: Mobile:089528508911
Whatsapp: 089528508911
Skype:………………………………..
11. Another way to contact you
BBM: :………………………………..
GTalk:………………………………..
12. When is the most ideal time to
Anytime Office hour only After office hour Others……………………..
call you by phone?
13. Email Address
14. Current employment (other
than “still studying” skip to number Employed Self employed Unemployed Still studying
16)
15. How long do you expect to be
3-6 months 6 months – 1 year More than a year
graduated?
16. Your ideal employment term Free lance Contract Part time Permanent
17. Are you willing to be a contract
Yes No
employee?
18. Are you willing to travel? Yes No
19. Are you willing to be stationed
Yes No
in BANDUNG?
20. Where did you get information
Instagram Job Street Website Social Media Others : Teman
about this job opening?
Candidate Interview Form PT. Inova Medika Solusindo
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II EDUCATIONAL BACKGROUND
Formal
School/ University Major Degree Place Year
SD SDN 1 BAMBE GRESIK 2009
SMP SMP YPM 1 TAMAN SIDOARJO 2012
SMA SMK YPM 2 TAMAN SIDOARJO 2015
ACADEMY
UNIVERSITY ITATS SURABAYA 2019
Judul Skripsi: Implementasi Algoritma Improved K-Means pada data titik panas (hotspot) permukaan
bumi
IPK : 3.53
Non Formal/ Training/ Course
1. AUTOCAD (SERTIVIKASI)
2. MS OFFICE (SERTIVIKASI)
3. ISQ (SERTIVIKASI)
4.
5.
III SKILLS
Language
Oral 1 2 3 4 5
21. Indonesia
Written 1 2 3 4 5
Oral 1 2 3 4 5
22. English
Written 1 2 3 4 5
Oral 1 2 3 4 5
23. Other:…………………..
Written 1 2 3 4 5
Computer Skills
24. Operating System/Tools Linux Ubuntu 1 2 3 4 5
Windows Vista 1 2 3 4 5
Candidate Interview Form PT. Inova Medika Solusindo
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Windows 7 1 2 3 4 5
Office Tools 1 2 3 4 5
Mac 1 2 3 4 5
Git (Source Code Manajemen) 1 2 3 4 5
Eclipse 1 2 3 4 5
Netbean 1 2 3 4 5
Other:……………………………………………. 1 2 3 4 5
Photoshop 1 2 3 4 5
CorelDraw 1 2 3 4 5
Illustrator 1 2 3 4 5
Freehand 1 2 3 4 5
25. Multimedia Inkscape 1 2 3 4 5
Macromedia 1 2 3 4 5
Gimpp 1 2 3 4 5
Fireworks 1 2 3 4 5
Other:……………………………………………. 1 2 3 4 5
HTML 5 1 2 3 4 5
CSS3 1 2 3 4 5
Jquery 1 2 3 4 5
CMS 1 2 3 4 5
26. Web Development
Ajax 1 2 3 4 5
Json 1 2 3 4 5
Javascript 1 2 3 4 5
Other:……………………………………………. 1 2 3 4 5
PostgreSQL 1 2 3 4 5
SQL Server 1 2 3 4 5
MySQL 1 2 3 4 5
27. Database & Reporting
Oracle 1 2 3 4 5
Reporting Service 1 2 3 4 5
Other:……………………………………………. 1 2 3 4 5
Candidate Interview Form PT. Inova Medika Solusindo
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PHP 1 2 3 4 5
Java 1 2 3 4 5
C# 1 2 3 4 5
Framework YII 1 2 3 4 5
28. Programming Language
C 1 2 3 4 5
C++ 1 2 3 4 5
Dot NET 1 2 3 4 5
Other:……………………………………………. 1 2 3 4 5
PC Setup 1 2 3 4 5
LAN 1 2 3 4 5
29. Hardware
WiFi 1 2 3 4 5
File/Print Server 1 2 3 4 5
Management Skills
Power Designer 1 2 3 4 5
Microsoft Project Management 1 2 3 4 5
Other: STAR UML 1 2 3 4 5
30. Tools
Other: HIREN’S 1 2 3 4 5
Other:……………………………………………. 1 2 3 4 5
Other:……………………………………………. 1 2 3 4 5
NOTE: 5 is the highest while 1 is the lowest
IV EMPLOYMENT HISTORY
31.
Company Name MULTI COM Position TEKNISI
From-to 2013 - 2015 Salary 1.500.000
SERVICE KOMPUTER ,LAPTOP DAN PRINTER
MONITOR
Job Description
Candidate Interview Form PT. Inova Medika Solusindo
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Likes Dislikes
32.
Company Name RSIA SOERYA Position STAFF IT
From-to Salary 2.000.000
MAINTENANCE NETWORKING ( SERVER , JARINGAN KABEL & WIFI )
MAINTENANCE PC DAN PERIPERAL (KOMPUTER, PRINTER, UPS)
MAINTENACE CCTV , NURCE CALL & LISTRIK
WEBSITE ADMINISTRATOR
Job Description SIMRS ADMINISTRATOR
Likes Dislikes
33.
Company Name Position
From-to Salary
Job Description
Likes Dislikes
V ADDITIONAL QUESTIONS
JUJUR, DISIPLIN, TANGGUNG JAWAB, TEKUN, SUKA BELAJAR, RELIGIUS, MUDAH BERADAPTASI
34. Your
DENGAN LINGKUNGAN SEKITAR
Strengths
SKIL : HARDWARE TROBLESHOTING DAN MAINTENANCE
35. Your
PENDIAM, PUBLIC SPEKING KURANG,
Weaknesses
36. Expected Rp. 4.200.000 (UMK) Negotiable
Salary Non-Negotiable
37. Availability Immediately 1 month notice Other:…………………..
Candidate Interview Form PT. Inova Medika Solusindo
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OKTAVIAN TEGAR
38. Candidate’s Signature 37. Interviewer’s Name
PAMBUDI
Candidate Interview Form PT. Inova Medika Solusindo
