ASTRA, a world of opportunities

APPLICATION FORM
Astra 1st Program

3x4
photograph

PERSONAL IDENTITY
Full Name: Tri Annisa Fajri
Place & Date of Birth: Pulau Jambu/ 11 Agustus 1992
Address: Jalan Parkit V nomor 14

Email: triannisafajri@rocketmail.com
Phone Number:
Mobile: 085271825143
EDUCATION BACKGROUND
High School : SMA I N Bangkinang, Riau Province
University: State Universitas of Padang

GPA: 3, 61

Faculty: Social Science

Semester: VI

Major: Geography

Credits have been taken: 114

Title of your final project: (Applying the biopore in boarding house Parkit V to increase groundwater)

Expected time of graduation (month and year): March 2013

SPECIAL COURSE / TRAINING ATTENDED:

Year

2010

Course / Training
Geographic Information System
Training (Based Level)

Place / Insitution
PPIDS (Pusat )

Remark

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
2009-now

2011-now

Activities /
Organization
PPIPM (The Center of
Research and Scientific
Develovment for
Student)

Organization
Scope
university

Position
Held
member

BEM FIS (students

executive council)

Faculty

Coordinator of
academic
reasoning

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

2011

Mahasiswa Berprestasi Tingkat

Fakultas
PKM P (Program Kreativitas
Mahasiswa-Penelitian)
PKM P (Program Kreativitas
Mahasiswa-Kewirausahaan)
MSQ (Musabaqah Tilawatil
Quran)

Universitas

2010
2010
2011

Dikti
Universitas
Universitas

Remarks

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, 22 March, 2011

Facebook: Astra Community
Twitter: AstraCommunity
Email: astra1st@astra.co.id

(Tri Annisa Fajri)

Signature & Full name

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)
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

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.
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________