Application SF
Name: *
Your answer
Nationality *
Your answer
Sex: *
Date of Birth: *
MM
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DD
/
YYYY
Religion *
Your answer
Mother's Full Name *
Your answer
Available Start Date *
MM
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DD
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YYYY
Email: *
Your answer
Mobile Phone: *
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Home Phone: *
Your answer
What Position and Department are you applying for? *
eg Math Teacher, Secondary
Your answer
Campus *
RH = Raffles Hills, Depok or PB = Permata Buana, West Jakarta
Emergency Contact Number *
Family Member or close friend (write name and number)
Your answer
Marital Status *
Year Married *
If not applicable type NA
Your answer
Number of Children *
If not applicable type NA
Your answer
Ages of Children *
If not applicable type NA
Your answer
Address *
Your answer
Bachelor Degree
University Name 1 *
Your answer
GPA & University Location 1 *
Eg. GPA350/Jakarta
Your answer
Degree Details 1 *
ie. Bachelor of Arts (English Literature)
Your answer
Years Attended 1 *
eg: July 2006 - June 2010
Your answer
Masters Degree
If not applicable leave this section blank
University Name 2
Your answer
GPA & University Location 2
Eg. GPA350/Jakarta
Your answer
Masters Details 2
ie. Masters of Education
Your answer
Years Attended 2
eg: July 2006 - June 2010
Your answer
Doctoral Degree
If not applicable leave this section blank
University Name 3
Your answer
GPA & University Location 3
Eg. GPA350/Jakarta
Your answer
Doctorate Details 3
ie. Doctorate of Education
Your answer
Years Attended 3
eg: July 2006 - June 2010
Your answer
Work History (Most Recent)
List the last three jobs you have had, starting with the most recent. If you have no experience please enter 'NA'.
Name of School/Company 1 *
Your answer
Position Held 1 *
Your answer
Location 1 *
Your answer
Years Worked (Include month) 1 *
July 2013 - June 2014
Your answer
Work History
Name of School/Company 2
Your answer
Position Held 2
Your answer
Location 2
Your answer
Years Worked (Include month) 2
July 2013 - June 2014
Your answer
Work History
Name of School/Company 3
Your answer
Position Held 3
Your answer
Location 3
Your answer
Years Worked (Include month) 3
July 2013 - June 2014
Your answer
Contactable Reference (Church)
Pastor/Priest Name: *
Your answer
Church Name *
Your answer
Pastor's Email *
Your answer
Pastor's Phone *
Your answer
Contactable Reference (Work/Study)
Supervisor's Name: *
Your answer
Organisation Name *
Your answer
Supervisor's Email *
Your answer
Supervisor's Phone *
Your answer
Other Information
Medical Information *
Report all medical conditions, and any afflictions that could cause you to miss working days.
Your answer
Criminal History *
Report any criminal convictions and charges.
Your answer
Why do you want to work in a Christian School? *
Your answer
Teacher Questions
If applying for a staff position type "NA" for each question
Describe the type of Christian teacher you will be if employed at Springfield *
Your answer
Discuss how you discipline students and manage your class *
Your answer
Please list any additional qualifications, certificates, and areas of expertise that you have *
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What extra curricula activities can you provide at Springfield? *
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List subjects/grades you are most qualified/willing to teach *
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Thank you for taking the time to fill in this application form. Please enter your full name again below to confirm that all the information you have provided is accurate and true. *
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