Lamaran

UNITED NATIONS DEVELOPMENT PROGRAM

Mayapada Tower II, Lt. 14, Jalan Jendral Sudirman Kav. 27, Karet, Setiabudi Jakarta
"INSTRUCTIONS

Please answer each question clearly and completely. Type or print in ink. Read carefully and follow all directions.
" "ATTACH
PHOTOGRAPH
HERE"
"UNITED NATIONS DEVELOPMENT PROGRAMME
PERSONAL HISTORY FORM
(for Service Contracts and Individual Contracts)
"

            PERSONAL                                
            HISTORY                             

1. A) Surname First Name Middle Name Maiden Name, if any
   MUHAMMAD IDRIS

   B) List any other names used

2. A) Permanent Address B) Telephone No.
   Jalan Miruk Taman Dusun Popeh No. 30 Desa Tanjung Selamat, Darussalam Aceh Besar 085246000978

3. A) Present Residence (Specify City, Province or State, Country) B) Since (date) Until (anticipated date) C) Telephone No.
   "JaJL .Medan-Banda Aceh,
   Paya Gajah Village Peureulak Sub-District, Aceh Timur - Aceh,
   " 16-Oct-83 82271458613

D) E-mail address (1) E) E-mail address (2), if applicable
m.idrisaceh@gmail.com

1. A) Place of Birth B) Date of Birth C) Citizenship at Birth D) Present Citizenship
   (If Swiss, canton and origin) 16-oct-1983 Indonesian Indonesian
   peureulak aceh timur

   E) Passport or Identity Card No. Date of Issue/Date of Expiry Place of Issue (in full)
   Passport: A 7069754 Issue: 11/06/2017 Expiry: 11/06/2022 Lhokseumawe

2. Sex (Check) 6. Marital Status (Check)

Male |√| Female || Single || Married |√| Widow(er) || Divorced || Separated |__|

1. Have you any depedents? Yes |√| No |__| If answer is "Yes" give following information:

Name Age Relationship Name Age Relationship
yusniar 35 Wife

"8. LANGUAGES
(List mother tongue first)"

Language READ WRITE SPEAK
Excellent Good Poor Excellent Good Poor Excellent Good Poor
Achenese √ √ √
Bahasa Indonesia √ √ √
English √ √ √
Arabic √ √ √

                                            Page 1 of 4