Form Astra

ASTRA, a world of opportunities APPLICATION FORM Astra 1st Program 3 x 4 photograph PERSONAL IDENTITY Full Name: Haryono Arif Place & Date of Birth: Pamekasan,16 juli 1989 Address: JL.P.Trunojoyo 357,Pamekasan-Madura Email: Haryoalmanduri@gmail.com Phone Number: 081944800744 Mobile: EDUCATION BACKGROUND High School : MAN University: HANG TUAH SURABAYA GPA: 3,34 Faculty: LAW FACULTY Semester: IV Major: Credits have been taken: Title of your final project: (if any) Expected time of graduation (month and year): SPECIAL COURSE / TRAINING ATTENDED: Year Course / Training Place / Insitution Remark 1 COURSE PAMEKASAN 1 ASTRA, a world of opportunities EXTRA CURRICULAR ACTIVITIES (specify organizational activities you have attended within a maximum of 2 years and showed the greatest contribution that you provide) Year Activities / Organization Organization Scope Position Held Responsibilities WORK EXPERIENCE (Including part time job, freelance, internship, etc.) Year Company Position Held Responsiblities SPECIAL AWARD Please mention award(s) you have been received and explain it briefly (academic honors, distinction, scholarship, etc) Year Award Institution Remarks 2 ASTRA, a world of opportunities INTEREST What do you usually do in your spare time? PERSONAL EVALUATION What make you different from others? What would you consider need to be improved in yourself? Would you like to participate in all programs provided during 1 year ? YES NO How do you know about Astra 1st Program ? University information board Friends / relatives www.astra.co.id other internet (facebook, email, mailing list, ......................) Jakarta, ………………., 2011 Facebook: Astra Community Twitter: AstraCommunity Email: astra1st@ai.astra.co.id ASTRA, a world of opportunities ACHIEVEMENT Personally, what is your greatest achievement(s), how do you accomplish it and why would you consider it as your greatest achievement(s) __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ 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__________________________________________________________________________________________ 4 ASTRA, A WORLD OF OPPORTUNITIES MOTIVATION & PERSONAL STRENGTH Explain to us, what is your biggest motivation(s) to join this program and why we need to choose you as one of Astra 1st candidates. __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ 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