INTERNSHIP APPLICATION FORM
Tax Number
(NPWP)
Bank Mandiri
Account Account Number:
Student Number
State 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 Data
Relation Name Birth date Occupation
Spouse
Education (list from latest education)
Professional Qualifications Achieved Professional
Licenses/Certification Year Institution
Training/Course/Seminar/Program
Training/Course/Seminar/Program Year Institution
Languages
Language Proficiency Qualification
English Mandarin
Personality
Describe your strength and weakness
Describe what
activities & interest do you have
Describe
achievement/things that you are proud of
Describe your family background
Organizational Background
Organization Name Position Year
References
Work Function Interest (sort three)
Capital Market Investment Banking Equity Research
Fixed Income Research Economic Research Strategy & Performance Accounting/Settlement Corporate Communication Human Capital/Human Resource Information Technology
Risk Management/Legal/Compliance
Time to Internship Program (tick one)
√ Duration Availability Join Date*
2 Months From to 3 Months From to More than 3 Months 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
Attach a photo/scanned of your ID card or passport here
Attach a photo/scanned of first page of your Bank Mandiri bankbook
