Form Employee Techdata
Form Employee Techdata
(Please affix a
recent passport
sized photograph)
PERSONAL PARTICULARS
Full Name : Mr/Mrs/Miss
Sex Nationality
CHILDREN PARTICULARS
Name Birth Date & Year Occupation (if any)
FAMILY PARTICULARS (Parents, Brothers, Sisters)
Mother
Brother/Sister
Brother/Sister
Brother/Sister
Brother/Sister
3.
Bachelor
Master
Doctor / PHD
Basic Salary
Allowance (please specify) (Rp. )
(Rp. )
(Rp. )
Other Benefits (please specify)
Basic Salary
Allowance (please specify) (Rp. )
(Rp. )
(Rp. )
Other Benefits (please specify)
Address : Address :
DECLARATION
1. Have you ever been charged and convicted in any Court of Law or detained under the YES / NO
provisions of any written law?
2. Have you ever been terminated / dismissed by your previous employer? YES / NO
3. Are you suffering or have you suffered any mental illness, physical handicap or disability? YES / NO
If yes, please specify ( )
4. Are you currently under any medication / treatment for any serious ailment/illness/disease? YES / NO
If yes, please specify ( )
5 Are you pregnant now? (for female applications only) YES / NO
6. Have you applied for a job in this company before? If so, when? YES / NO
________________________
7.Do you have any relatives or friends working in PT. Tech Data Advanced Solutions Indonesia YES / NO
If yes, please give details
Name Relationship Position in Company
I, hereby declare that all particulars given above are to the best of my knowledge, true and correct. This declaration
shall, if I am employed, constitute an integral part of the Contract of Service between the company and I. I agree
that if the Declaration is in any part false or incorrect, the company reserves the right to terminate my services
instantly. I also understand that the Company would be conducting background / reference checks on my previous
employers and I would not hold the Company liable for any problems / issues arising from these checks if it directly
/ indirectly affects my current employment status
________________________________ _____________________________
Signature of Applicant Date