Print application form Application form Geologist 922727 Title: First name: Preferred name: Last name: Email address: Home address: City/Suburb/Town: Country: PostCode/Zip: Phone number: Mobile number: You will not be charged any money or required to perform any service to Thiess or any of its employees in this recruitment process to gain employment. If you are requested to pay a fee or perform a service, please report the name of the person, the title of the job you were interviewed for or seeking to be hired for, the date and location where the incident occurred. Anda tidak dipungut bayaran berupa uang atau diminta untuk memberikan jasa kepada Thiess atau Karyawan dalam proses penerimaan Karyawan untuk memperoleh pekerjaan. Jika Anda diminta untuk membayar sejumlah uang atau memberikan jasa, silahkan melaporkan nama orang tersebut, posisi pekerjaan yang Anda diwawancarai atau posisi yang Anda lamar, tanggal dan lokasi dimana hal tersebut terjadi. Apakah anda warga negara Indonesia (Are you an Indonesian Citizen)?* Ya (Yes) Tidak (No) KTP no. (ID no.)* Tanggal diterbitkan KTP (KTP issue date)* KTP berlaku hingga (KTP expiry date)* Tempat diterbitkan KTP (KTP place of issue)* Foto kopi KTP (copy of KTP)* (File upload facility available online) Tanggal lahir (date of birth)* Tempat lahir (place of birth)* Jenis kelamin (gender)* Laki Laki (Male) Perempuan (Female) Agama (Religion)* Buddhist Catholic Confucianism Hindu Muslim Protestant Other Menikah (married) Belum menikah

Application Form - Geologist - 922727

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5/9/2015 ApplicationformGeologist922727

https://secure.pageuppeople.com/apply/399/iw/applicationForm/buildPrintableForm.asp?lJobID=922727&lJobSourceTypeID=269&sLanguage=en 1/2

PrintapplicationformApplicationformGeologist922727

Title: Firstname:

Preferredname: Lastname:

Emailaddress:

Homeaddress:

City/Suburb/Town:

Country: PostCode/Zip:

Phonenumber: Mobilenumber:

YouwillnotbechargedanymoneyorrequiredtoperformanyservicetoThiessoranyofitsemployeesinthisrecruitmentprocesstogainemployment.Ifyouarerequestedtopayafeeorperformaservice,pleasereportthenameoftheperson,thetitleofthejobyouwereinterviewedfororseekingtobehiredfor,thedateandlocationwheretheincidentoccurred.AndatidakdipungutbayaranberupauangataudimintauntukmemberikanjasakepadaThiessatauKaryawandalamprosespenerimaanKaryawanuntukmemperolehpekerjaan.JikaAndadimintauntukmembayarsejumlahuangataumemberikanjasa,silahkanmelaporkannamaorangtersebut,posisipekerjaanyangAndadiwawancaraiatauposisiyangAndalamar,tanggaldanlokasidimanahaltersebutterjadi.ApakahandawarganegaraIndonesia(AreyouanIndonesianCitizen)?* Ya(Yes) Tidak(No)

KTPno.(IDno.)* TanggalditerbitkanKTP(KTPissuedate)*

KTPberlakuhingga(KTPexpirydate)*

TempatditerbitkanKTP(KTPplaceofissue)* FotokopiKTP(copyofKTP)*

(Fileuploadfacilityavailableonline)Tanggallahir(dateofbirth)*

Tempatlahir(placeofbirth)*

Jeniskelamin(gender)* LakiLaki(Male) Perempuan(Female)

Agama(Religion)*

Buddhist CatholicConfucianism HinduMuslim ProtestantOther

Menikah(married) Belummenikah
5/9/2015 ApplicationformGeologist922727

https://secure.pageuppeople.com/apply/399/iw/applicationForm/buildPrintableForm.asp?lJobID=922727&lJobSourceTypeID=269&sLanguage=en 2/2

Statuspernikahan(maritalstatus)* (single)Cerai(divorced)

Jumlahtanggungan(numberofdependents)* Apakahandamemilikikeluarga/kenalanyangbekerjadiThiess(DoyouhaveanyfamilyorfriendswhoworkforThiess)?*

Ya(Yes) Tidak(No)

Nama&jabatanorangtersebut(Pleasestatename&positionoftheabove)

Detailyoureducationhistory:

Detailyouremploymenthistory:

Pleaseuploadyourresume*

(Fileuploadfacilityavailableonline)Pleaseuploadyourcoverletter

(Fileuploadfacilityavailableonline)Pleasenoteweonlyacceptuploadeddocumentsinthefollowingformat(.DOC,.PDF,.XLS,.PPT,.JPEG,.TIF)