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SELEKSI TERBUKA JPT PRATAMA DI LINGKUNGAN PEMERINTAH PROVINSI LAMPUNG 2019
Formulir pengisian Seleksi Jabatan Pimpinan Tinggi Pratama di Lingkungan Pemerintah Provinsi Lampung Melalui Online Media
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Nomor Induk Pegawai
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2
Nama Pegawai
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Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
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eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
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Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
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Uruguay
Uzbekistan
Vanuatu
Vatican City
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8
Nomor Hp
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9
Email
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10
Scan e-KTP
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11
Surat Lamaran yang ditulis tangan dan ditanda tangani sendiri dengan tinta hitam dan bermaterai Rp. 6000 ditujukan kepada Ketua Panitia Seleksi
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Pernyataan Pakta Integritas dan bermeterai Rp. 6000 yang ditanda tangani
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Scan Ijazah terakhir yang dilegalisir oleh pejabat yang berwenang (jpg/pdf)
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14
File Daftar Riwayat Hidup/Curiculum Vitae/Bio Data/Profil PNS sesuai dengan format Peraturan Kepala BKN Nomor 13 Tahun 2006
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Scan Surat rekomendasi/ijin dari Pejabat Pembina Kepegawaian/PPK (jpg/pdf)
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16
Scan SK Jabatan (yang sedang atau pernah diduduki) yang dilegalisir (jpg/pdf)
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Scan SK CPNS, SK PNS dan SK Pangkat terakhir yang dilegalisir (jpg/pdf)
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Scan Sertifikat Diklat Diklat Kepemimpinan yang dilegalisir (jpg/pdf)
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Scan Sertifikat Diklat Teknis maupun Fungsional yang dilegalisir (jpg/pdf)
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20
Hasil Penilaian Prestasi Kerja PNS 2 (dua) Tahun terakhir (SKP) berdasarkan Peraturan Pemerintah Nomor 46 Tahun 2011 yang ketentuan pelaksanaanya diatur dalam Peraturan Kepala Badan Kepegawaian Negara Nomor 1 Tahun 2013 yang dilegalisir
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NPWP yang dilegalisir
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Bukti Penyampaian Laporan Harta Kekayaan Pejabat Negara (LHKPN)
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Bukti Penyampian Pelaporan SPT tahun terakhir
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File pokok-pokok pikiran dalam bentuk makalah
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File Presentasi Terkait Jabatan yang di lamar
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Pas Foto terbaru ukuran 4 x 6 cm dengan latar belakang warna merah
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Surat Keterangan Hasil Tes Kesehatan dari Rumah Sakit Pemerintah
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Surat Keterangan Hasil Tes Kesehatan dari Rumah Sakit Jiwa Pemerintah/Swasta yang berwenang
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Surat Keterangan Bebas Narkoba dari Instansi yang berwenang
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Surat Keterangan Catatan Kepolisian (SKCK)
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31
Surat pernyataan tidakpernah/sedang atau berat dijatuhi hukuman disiplin atau tidak dalam proses pemeriksaan pelanggaran disiplin yang dikeluarkan Aparatur Pengawas Internal Pemerintah/APIP
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