petronas overseas talent sourcing.pdf
TRANSCRIPT
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19/5/2015 PETRONASOverseasTalentSourcing
http://www.utp.edu.my/POTS/submit.php 1/3
A.APPLICATIONDETAILS REFERENCENO:512975
ProgrammeofStudy:MScinAdvancedProcessControlbyCoursework&Dissertation
B.PERSONALDETAILS
FullName: FaizGender: Male PassportNo: A0449097DateofBirth: 10/08/1988 PlaceOfBirth: Sumenep
Age: MaritalStatus:
Nationality: IndonesiaMailingAddress: SuwaluhSelatanRT.18/RW.05KelurahanSuwaluh,KecamatanBalongbendo
Postcode: 61263 City: Sidoarjo State/Province: EastJava Country: Indonesia
TelNo: +6283896393309 MobileNo:+6287877223338 Email: [email protected]
PermanentAddress@HomeCountry(ifdifferentfromMailingaddress):
Postcode: City: State/Province: Country: Indonesia
C.QUALIFICATIONS
PleaseprovidedetailsofdegreeobtainedfromUniversity/College/OtherTertiaryInstitutions
AcademicQualificationObtained
Result/Achievement(CGPAorequivalent)
NameofInstitutionPeriodofstudy Languageof
InstructionFrom To
BachelorDegreeEngineeringPhysics 3.19
InstitutTeknologiSepuluhNopember 08/2006 03/2011
Bahasa,English
OtherProfessionalQualifications:
ResearchExperience:
Publication(providecitations):
D.LANGUAGEPROFICIENCYProficiencyinEnglishlanguage(Forallapplicants)
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19/5/2015 PETRONASOverseasTalentSourcing
http://www.utp.edu.my/POTS/submit.php 2/3
Test DateTaken Grade/PointObtained
1.
2.
3.
4.
E.WORKINGEXPERIENCE
Pleaseprovidedetailsofcurrentandpreviousemployment(startwiththemostrecent)
PresentPosition: MeteringEngineer Since: 04/05/2015BusinessAddress: YokogawaIndonesia,PlazaOleos,3rdFloor,SuiteAH.Jl.TB.SimatupangKav.53.SouthJakarta
Postcode: 12520 Country: Indonesia TelNo: FaxNo: Email: [email protected]
From To PositionandNatureofWork Employer
03/02/2014 25/04/2015 InstrumentandControlCommissioningEngineerPT.TRIPATRAENGINEERSAND
CONSTRUCTORS04/04/2011 31/01/2014 ServiceEngineer(Metering) PT.CONTROLSYSTEMSAPN.
F.HEALTHINFORMATION
NO
G.REFEREES
Pleaseprovidedetailsoftworefereeswhoareabletocommentonyouracademiccapabilities.
Name Organization Tel.No. EmailAddress1.BagasIsadewa IntechProcessAutomationIndonesia +6282141503888 [email protected]
2.RommyAprilianto PetroChinaInternationalJabung,Ltd +6281259990037
H.PERSONTOBENOTIFIEDINCASEOFEMERGENCY
Name: FitriNoerLaili Relationship: WifeAddress: SuwaluhSelatanRT.18/RW.05KelurahanSuwaluh,KecamatanBalongbendo Postcode: 61263 City: Sidoarjo State: EastJava Country: IndonesiaTelNo: +6287877223336 FaxNo: Email:
I.NEXTOFKIN
Name: Relationship: WifeAddress:
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19/5/2015 PETRONASOverseasTalentSourcing
http://www.utp.edu.my/POTS/submit.php 3/3
Postcode: 61263 City: Sidoarjo State: EastJava Country: Indonesia
TelNo: +6287877223336 FaxNo: Email:
J.CONSENT
1. IherebygivemyconsentforPETRONAStoutilisetheinformationasIhavefurnishedforthepurposeofprocessingsponsorshipapplication.Intheeventthattheapplicationissuccessful,thisconsentisalsoextendedtoanyreleaseofdatabyPETRONASforthepurposeofacquiringuniversityplacement/entrance.
2. Allinformationgivenaboveareaccurateandtrue.Allcopiesofcertificatesandrelateddocumentsthatwillbesentsubsequentlytosupportthisapplicationiscorrectandvalidasrequired.
3. IagreethatPETRONAShastherighttorejectthisapplicationorwithdrawanyoffer(ifmade)atanytime,ifanyoftheinformationarefoundtobefalseand/oruntrue.
K.DECLARATIONIherebydeclarethatIhavepersonallyfilledinthisApplicationFormandthattheinformationcontainedhereiniscompleteandaccuratetothebestofmyknowledge.Iunderstandthatwithholdingorgivingfalseinformationwillmakemeineligibleforadmissionandfutureenrollment.Ifurtherunderstandthatifatanytimetheinformationorpartthereofstatedinthisdeclarationisfoundcontrarytofacts,theUniversityhastheauthoritytodisqualify,orifIamalreadyadmitted,toterminatemycandidature.
SignatureofApplicant Date 19May2015
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