Application Form

Assistant Manager of Human Resources Management Department

What is meant by family is father, mother, siblings, spouse and children (if any).

Tables below are for past education (not latest)

For several files to be uploaded, please do not use unusual character such as ` or ' in the file name.

Please note that all applicants who applying for PT MMKSI's vacancy are require to submit an introduction video, as part of the recruitment process. The video submission is aim to gain a better understanding on your qualifications and capabilities. Please access the link below for more detailed instructions and introduction video requirements: https://bit.ly/PTMMKSIVideoRequirements

CONSENT FORM

I hereby certify that all information on this form is updated, true, and correct. Therefore, I agree to allow PT MITSUBISHI MOTORS KRAMA YUDHA SALES INDONESIA (“PT MMKSI”) to store, use, and process my personal data as stated on this application form.

Herewith I authorize PT MMKSI to acquire additional information from relevant parties to verify the accuracy of the personal data provided in this application. In the event of any inaccurate or false information, whether partially or entirely, I consent to accept sanctions, including the cancellation of my recruitment process or termination of my employment, should I be accepted as an employee. I also consent to the sharing of my personal data with third parties, affiliates, or service providers as necessary for the fulfillment of the recruitment purposes.

By clicking the checkbox, I am stating explicitly that my consent is true and made without coercion from any party. I agree to accept sanctions in accordance with company policies and Indonesian laws and regulations if I act against the given consent without providing a cancellation and/or termination statement for the consent.

I have read all the content of PDP Policy Consent, and I Hereby Agree and Accept the PDP Policy Consent

PERSONAL INFORMATION

What is your name? *

What is your email? *

What is your date of birth? *

Place of Birth *

What is your address? *

What is your ID card number? *

What is your phone number? *

What is your mobile number? *

Hobby *

EDUCATION & EXPERIENCE

Please fill your latest education below

Past Formal Educations *

Institution	Faculty	Major	Level	GPA	Start	End
Add a line

Past Informal Educations *

Module/Topic	Institution	Certified	Start	End
Add a line

Organizations *

Organization Name	Position	Start	End
Add a line

Work Experiences *

I have prior job experience

Work Experiences *

Start Date	End Date	I Currently Work Here	Company Name	Position	Job Description	Reason for Leaving	Salary	Company Telephone Number
Add a line

Language Proficiency *

Language	Proficiency Test	Score
Add a line

FAMILY BACKGROUND

Family Members *

Relationship	Name	Age	Occupation	Institution	Position
Add a line

Employement History in Mitsubishi Group Companies

Yes
No

Mitsubishi Group Companies Relationship *

Relationship	Name	Institution	Position
Add a line

MEDICAL CHECK LIST

Please answer the following questions according to your health condition and your family. What is meant by family is father, mother, siblings, spouse and children (if any).

1. Do you have any smoking habit? * Yes No

2. Do you have a history of short breath? * Yes No

3. Have you ever cough and bleed? * Yes No

4. Have you or your family ever had jaundice (penyakit kuning)? * Yes No

5. Do you or your family have a history of hepatitis? * Yes No

6. Do you or your family have a history of diabetes? * Yes No

7. Do you or your family have a history of hypertension / high blood pressure? * Yes No

8. Do you or your family have a history of urinating stones / bloody urine/ urinating festering? * Yes No

9. Do you or your family have a history of epilepsy? * Yes No

10. Do you or your family have a history of congenital heart disease? * Yes No

11. Do you or your family have a history of lumps / tumors / cancer? * Yes No

12. Do you or your family have a history of nephrotic syndrome / kidney failure? * Yes No

13. Do you or your family have a history of blood disorders (such as thalassemia, hemofilia, anemia)? * Yes No

14. Do you or your family have a history of autoimmune disease? * Yes No

15. Do you or your family have a history of hearing loss? * Yes No

16. Is there a history of chronic skin disease that require continuous treatment? * Yes No

17. Do you have any illnesses or symptoms other than those listed above? Please explain * Yes No

18. Have you had any medical surgery? * Yes No

19. Have you ever been treated in a hospital? * Yes No

20. Have you ever had an accident? * Yes No

21. Have you taken any medications in the last 3 months consecutively? * Yes No

22. In the last 12 months, have you experienced any significant weight changes? * Yes No

I hereby certify that all the Information stated on this form is true and correct, therefore it can be used as a reference on my employment selection process. If there is in such information stated therein is incorrect, either partially or entirely, so I am prepared to accept any sanction as cancellation of my participation on this selection or by termination of employment pursuant to prevailing laws and regulations, if I have been promoted as an employee. I herewith give authorization to PT MITSUBISHI MOTORS KRAMA YUDHA SALES INDONESIA to obtain more clear information regarding me or the correctness of the information stated therein to any certain parties.

APPLICATION CONFIRMATION & ATTACHMENT

What is your last drawn salary? *

What is your expected salary? *

Would you like to be considered for other positions for which you may be qualified? * Yes No

What source(s) of information influenced your decision to apply for a MMKSI position? *

ID Card *

Photos *

Graduation Certificate *

Graduation Transcript *

Portfolio (if any) *

CV/Resume *

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