application form internship 2016 v2
DESCRIPTION
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INTERNSHIP APPLICATION FORM
Personal DataName
Nickname
Place/Birth date
Religion
Address
Marital Status
ID Number (KTP/Passport)Tax Number (NPWP)
Bank Account Bank:
Account Number:
Student Number
Telephone Home:
Mobile:
Emergency Contact Name:
Phone:
Address:
Photograph
Physical ConditionState if there is any physical disability
State if you have any major illness/accident in the last six months
State your weight and height
State your blood type
Family DataRelation Name Birth date Occupation
Spouse
Child (1)
Child (2)
Child (3)
Father
Mother
Sister (1)
Sister (2)
Sister (3)
Brother (1)
Brother (2)
Brother (3)
Education (list from latest education)School/University Major Year GPA/Honors
Professional Qualifications AchievedProfessional Licenses/Certification Year Institution
Training/Course/Seminar/ProgramTraining/Course/Seminar/Program Year Institution
LanguagesLanguage Proficiency Qualification (TOEFL/TOEIC/etc)
Bahasa
English
Mandarin
PersonalityDescribe your strength and weakness
Describe what activities & interest do you have
Describe achievement/things that you are proud of
Describe your family background
Organizational BackgroundOrganization Name Position Year
ReferencesName Address Telephone Occupation
Work Function Interest (sort three alternatives)Capital Market RetailCapital Market InstitutionalInvestment BankingResearch (Equity/Fixed Income/Economic)Accounting/Finance/Treasury/SettlementStrategy, Performance & Business DevelopmentCorporate CommunicationHuman Capital/Human ResourceInformation TechnologyRisk Management/Legal/Compliance/Internal Audit
Time to Internship Program (tick one)√ Duration Availability Join Date*
1 Month From to2 Months From to3 Months From toOthers ( ) From to
*please take attention when deciding joining date. Join date mean the date that you available to start your internship program (exclude duration). Sample; if you inform your availability join date from 29-31 July with 2 months duration, we will assume your requested internship period by 29 July – 28 September or 31 July – 30 September.
______________________ ______________________Signature & Name Date
Please attach a photo/scanned of your ID card or passport (first and last page) here (First identity page and last page for passport)