Employment

Application

Position Applied : Branch Manager KCP Genteng - Banyuwangi

Expected Salary : IDR 15.000.000,-

Referral Source :

Advertisement Employee Other Employment Agency

Name of Source ( if applicable) : DHARMA SENTIKO

1. PERSONAL RECORD

Name: SURYADI Sex : Male ID # 3510092903830004

Address : Perum Bukit Permai Blok F-30

Lingk. Sumberdandang, Kebonsari, Sumbersari
Jember 68122

Telephone: (Home) :       Office :       HP 0812 3117 4498

Email address : surya4d1@gmail.com / surya4d1@yahoo.com

Place / Date of Birth : Banyuwangi, March 29, 1983

Nationality : Indonesia Religion : Islam

Marital Status : Married Number of Children : 2

Interest : Reading

Have you ever been employed by Shinhan Bank/Bank Metro Express/Centratama Nasional Bank or any of their
affiliates?
Yes No

If yes, which one and when?       Reason for Leaving :      

Do you relate to any of our employees? Yes No

If yes, please write down the name of the employee and your relationship with him/her :      

In case of emergency, person to be contacted:

Bank Shinhan Indonesia, International Financial Center 2, 30-31 FI. JI. Jend. Sudirman Kav. 22-23 Jakarta 12920 -Indonesia
Name : Achmad Basuki Address : Jl Raya Kembiritan No 171, Genteng, BWI

Telephone : 0333-846203 Relationship : Parent

2. HEALTH CONDITION
Your health condition : Excellent Good Fair Poor

Eyesight : Normal Eyeglasses Color Blind

PHOTO

optional

Hearing : Normal Deaf

Other health problem, specify :      

     

3. FAMILY MEMBERS

Spouse & Children

Name Sex Highest Level Current Employment
Age
F/M Attained (Company/Title)
Spouse Ana Sri Agustin F 35 Degree NA

1st Child Ahza Adi Aryasatya M 7 NA NA

2nd Child Ammar Adi Alfarizqi M 5 NA NA
3rd Child                              

4 th Child                              

                                   

Parents & Sibling (included yourself)

Name Sex Highest Level Current Employment
Age
F/M Attained (Company/Title)
Father Achmad Basuki M 63 High School Retired

Mother Munawaroh F 58 Degree Government / Teacher

1st Child Mochamad Fachrudin M 38 Degree BP Batam / Consultant
2nd Child Suryadi M 35 Degree Maybank Indonesia / Officer

3rd Child Heni Sulistyowati F 30 Degree NA

4 th Child                              

                                   

Bank Shinhan Indonesia, International Financial Center 2, 30-31 FI. JI. Jend. Sudirman Kav. 22-23 Jakarta 12920 -Indonesia
4. PERSONAL REFERENCE (not relative)

Name Occupation Business address Telephone Number

                       

                       

5. EDUCATION I ACHIEVEMENTS

Formal Education
Name of Scholl/ Certificate/ Diploma/
Level Major Period
College/ University Degree
Primary SD Muhammadiyah       1992 - 1997      
06 Genteng
Lower Secondary SMPN 1 Genteng       1997 - 1999      
Higher Secondary SMAN 1 Genteng       1999 - 2001      
Academy                        
University Jember University International Relation 2001 - 2007 Sarjana Sosial
- Faculty of Social &
Political Science
                             

Informal Education
Courses of Study Period Certificate

                 

                 
                 

Professional Qualifications
Professional Qualifications Date of Issue Name of Issuing Organization

Officer Development Program December 11, 2009 Bank Internasional Indonesia

                 
                 

Foreign Language Skill

Written Spoken
Language
Excellent Good Fair Poor Excellent Good Fair Poor
English       Good                         Fair      
                                                     
                                                     

Bank Shinhan Indonesia, International Financial Center 2, 30-31 FI. JI. Jend. Sudirman Kav. 22-23 Jakarta 12920 -Indonesia
Organization Involvement
Name Type of Activity Period Your Role

                       

                       
                       

6. EMPLOYMENT RECORD

List your last three (3) employers (starting with the latest employment)

Company’s Name, Rate of Pay Job Title/

Address and Department Report to
Period Reason for Leaving
Telephone Number Name/Title

2008 - Current Bank Maybank IDR 8.775.900,- Relationship Ariestya NA

Indonesia, KC Officer / Rostanti /
Jember - Jl Gatot SME SME
Subroto No 48 Manager
Jember, 0331-487972

Describe your job-related responsibilities and key accomplishments: Obtain new business / customer and Maintain /
retain eksisting customer, Cross selling non SME Lending product

     

     

Company’s Name, Rate of Pay Job Title/

Address and Department Report to
Period Reason for Leaving
Telephone Number Name/Title

2007 - 2008 Okezone.com / IDR 1.500.000,- Reporter Syukri Financial & Work
MNC Tower 12th Rahmatullah Location
Floor, Jl Kebon Sirih / Editor
Kav 17-19 Menteng,
DKI Jakarta - 021
3924706

Describe your job-related responsibilities and key accomplishments: Act as news reporter in the field of politics,
social & law that worked in line with strict deadline.

     

     

Company’s Name, Rate of Pay Job Title/

Address and Department Report to
Period Reason for Leaving
Telephone Number Name/Title

                                   

Bank Shinhan Indonesia, International Financial Center 2, 30-31 FI. JI. Jend. Sudirman Kav. 22-23 Jakarta 12920 -Indonesia
Describe your job-related responsibilities and key accomplishments:      

     

     

May we contact your previous employers for job-related information ? Yes No

Explain any gaps in employment (if the are any):      

     

     

7. WILLINGNESS TOWARDS WORKING CONDITIONS ()

Not a problem (√) Prefer not to (√) / Reason

Job Rotation √            

Overtime       √ Prefer to getting the work done in line with
working days / hours. If needed, overtime is not
a concern
Travelling √            

Are you currently engaged in a contract with other company? Yes No

If yes, please specify : Relationship Officer of Bank Maybank Indonesia

When is your availability to join the company : 2 months notice

I declare that I never been involved in any kind of fraud in my previous bank, and acknowledge that any

misrepresentation I write on this application form will be sufficient cause for cancellation of this recruitment process

and/or termination of employment with Bank Shinhan Indonesia in the future.

This certifies that this application form was completed by me and that all information provided is true and to the best of

my knowledge.

SURYADI July 16, 2018

Bank Shinhan Indonesia, International Financial Center 2, 30-31 FI. JI. Jend. Sudirman Kav. 22-23 Jakarta 12920 -Indonesia
Applicant’s Signature Date

Bank Shinhan Indonesia, International Financial Center 2, 30-31 FI. JI. Jend. Sudirman Kav. 22-23 Jakarta 12920 -Indonesia