Vous êtes sur la page 1sur 4

APPLICATION FORM

I PERSONAL DETAILS
1. Full Name (Male / Female)
2. Date & Place of Birth
3. Nationality ID Card Number
4. Religion
5. Address
6. Phone No (Home) (Mobile)
7. E-mail Address
8. Marital Status Single Married Widow Widower
9. Number of Children
10. Please write where and how do you know about vacancy

II FORMAL EDUCATION
Education Level School’s Name Year Graduate Year Major In (GPA)
Primary

Junior High School

High School

Academy

University

Others

INFORMAL EDUCATION (COURSE – UPGRADING COURSE, ETC)


Course Name Organizer Place/Time & Period Diploma/Non Diploma

FOREIGN LANGUAGE & DIALECT (GOOD – FAIR – BELOW STANDARD)


Language Reading Writing Communicating Comment

English

III OTHER PROFESSIONAL QUALIFICATION


1. Do you have other teacher training certificate?

2. Did you ever take any English proficiency test, such as: Cambridge exam/ IELTS/ TOEIC/ TOEFL (IBT or PBT)? If yes, please
write the score and the year it was taken.
IV ENGLISH LANGUAGE TEACHING EXPERIENCES:

Date/ Name of Level and age Starting pay per hour/ Last pay per Reason Leaving
Month/ Year Institution group per month hour/per month

1. Describe in some details your preferred approach on teaching English as a foreign language.

2. When teaching you give hand-outs to the students. One of your student crumples the paper and put in the waste-paper
basket. Please write in details what would you do in that situation!

3. Why do you think you would be suited to this job?

V OTHER PREVIOUS WORK EXPERIENCE

Name & Address of Held Dates Employed (from Last Salary Reason for Leaving
Company – to)

VI FAMILY INFORMATION

1. You live in a house or apartment:


a. Of your Own b. Of your Parents c. Renting d. Boarding
2. Number of family members person
3 Family Composition (Wife – Husband – Children – Parents – Parents in law – Brothers/Sisters)

Name Family Relation Place & Date of Birth Job Address

4. Medical Record

a. Do you have any allergies or illness you need to inform us of?


A. Yes B. No
If yes, please circle the options below:
a. Epilepsy g. Hemorrhoid/ Wasir m. Cancer related
b. Hypertension h. Cataract
c. Asthma/TBC i. Lymphoid/ Amandel n. Gastritir
d. Rheumatic related j. Kidney/ Ginjal o. Others: …………………………………..
e. Sinusitis k. Heart disease
f. Stroke l. Diabetes
b. Have you been hospitalized for any serious illness or injury?
A. Yes B. No
It yes please state nature of illness or injury and length of stay in hospital or recovery time:

VII OUR FRANCHISE


There are 10 EF schools in our franchise, EF Pluit, Tebet, Tanjung Duren, Puri, Cengkareng, BSD Tangerang, Gading Serpong ,
Tangerang City, Bogor Padjajaran, & Bogor Yasmin

1. Will you be able to be located in any of our EF schools?

2. Please write 3 school locations that you prefer (based on your priority to be located by referring to the list above)
a.
b.
c.

Apart from adult classes and in-company training, a lot of our students are young learner age 4-14 years old
3. Will you have a problem with teaching the above age range?

4. How do you like teaching the above range?

5. Will that be a problem for you?

Most of the teaching hours are Monday/ Wednesday/ Friday:


1. 2:00 pm – 3:00 pm 2. 3:00 pm– 4:30pm 3. 4:30pm – 5:50pm 4. 6:00pm – 7:20pm
Tuesday/ Thursday:
2. 2:00 pm – 3:00 pm 2. 3:00 pm– 4:30pm 3. 4:30pm – 5:50pm 4. 6:00pm – 7:20pm

6. Your chances of getting hired will also depend on how available you are on the above hours.
a. Are you free to teach everyday (Monday to Friday) between 2:00pm – 9:00 pm?
b. Are you free to teach on Mon/ Wed/ Fri between 2:00pm – 9:00pm?
c. Are you free to teach on Tuesday and Thursday between 2:00pm – 9:00pm?
d. Are you free to teach on Saturday between 9:00am – 3:00pm?

7. Are you applying for?


a. Teaching Assistant b. Full time teacher c. Whichever available
8. When is your earliest availability to start working?

9. If not, what length of time must you give?

10. What is your pay expectation?


- Monthly: Rp. …………………………….. / month
- Hourly: Rp. ……………………………….. / hour
VIII OTHER INFORMATION

1. Name of Reference (Work) :

Name Address & Phone No. Job

2. Emergency Contacts :

Name Address & Phone No Job

3. Name of employee you know already working with English First (N/A if not applicable) :

Name Address & Phone No Job

4. Driving license type : Expiry date:

5. Blood type : A B AB O

The information I have provided on this application form is accurate to the best of my knowledge.
I agree to accept responsibility for omission regarding my failure to disclose any relevant information.
Jakarta,…………………………………....

(…………………………………………………)

Please write your social media username:

Name of Recommendation :

Name/Home Area Recommendation for


Phone Education Background
( ex. Rika/Cengkareng) ( Teacher/Staff)