Chỉnh sửa:

vib form

céng hoµ x· héi chñ nghÜa viÖt nam

®éc lËp - tù do - h¹nh phóc

®¬n xin viÖc

§IÒn ®Çy ®ñ vµ râ rµng th«ng tin cho mçi c©u hái.Kh«ng ®îc viÕt vµo phÇn t« ®Ëm

§äc kü c¸c híng dÉn kÌm theo ë m«I c©u hái

M· sè dù tuy

S¬ yÕu lý lÞch nµy chØ cã gi¸ trÞ tèi ®a lµ 6 th¸ng kÓ tõ ngµy khai

Anh/chÞ cã thÓ ®Ò nghÞ gi¶i thÝch thªm ®Ó ®¶m b¶o hiÓu râ c¸c c©u hái

¦u tiªn 1

¦u tiªn 2

¶nh 4 x 6

Hä vµ tªn ®Öm

Tªn chÝnh

Sè CMT ND

N¬i ®¨ng ký hé khÈu thêng tró (sè phßng - sè nhµ / ngâ - phè - th«n - xãm / phêng - x· / quËn-huyÖn / TØnh-Thµnh phè):

Sè ®IÖn tho¹i

Nhµ

M· vïng

N¬i kh¸c

§Þa chØ liªn hÖ (sè phßng - sè nhµ / ngâ - phè - th«n - xãm / phêng - x· / quËn-huyÖn / TØnh-Thµnh phè):

Tel/Fax

E-mail

Giíi tÝnh

ChiÒu cao

C©n nÆng

T×nh tr¹ng h«n nh©n

Nam

N÷

(cm.)

(Kg.)

Cha kÕt h«n

§· kÕt h«n

Kh¸c (ViÕt cô thÓ)

Ngµy th¸ng n¨m sinh

N¬i sinh

Ngµy

Th¸ng

N¨m

(TØnh/Thµnh phè)

10.

Thµnh phÇn gia ®×nh: (Chång/Vî,Con, Cha mÑ, Cha mÑ chång/vî, Anh chÞ em ruét)

Hä vµ tªn

Quan hÖ

NghÒ nghiÖp, n¬i lµm viÖc

§Þa chØ c¬ quan/ ®iÖn tho¹i

11.

Ghi râ nghÒ nghiÖp vµ tªn c¬ quan Vî/Chång (nÕu c

§iÒn c¸c ng«n ng÷ mµ anh/chÞ biÕt (b¾t ®Çu b»ng tiÕng Anh). Xin viÕt râ kh¶ n¨ng sö dông tõng kü n¨ng

Ngo¹i ng÷

ViÕt

Nghe

Nãi

§äc

Tèt

Kh¸

Tèt

Kh¸

Tèt

Kh¸

Tèt

Kh¸

TiÕng Anh

Qu¸ tr×nh ®µo t¹o: (Ghi ®Çy ®ñ vµ chi tiÕt)

Trung häc hoÆc c¸c lo¹i h×nh ®µo t¹o kh¸c tõ 14 tuæi (VD: Trêng trung häc kü thuËt hoÆc d¹y nghÒ)

Thêi gian ®µo t¹o

Tõ

§Õn

Chøng chØ, phÇn thëng

Tªn trêng, Thµnh phè, §Êt níc

Th¸ng

N¨m

Th¸ng

N¨m

LÜnh vùc ®µo t¹o

hoÆc danh hiÖu ®îc nhËn

Trêng ®¹i häc

Thêi gian ®µo t¹o

Tõ

§Õn

Tªn trêng, Thµnh phè, §Êt níc

Th¸ng

N¨m

Th¸ng

N¨m

LÜnh vùc ®µo t¹o

B»ng cÊp

§µo t¹o sau ®¹i häc

Thêi gian ®µo t¹o

Tõ

§Õn

Tªn trêng, Thµnh phè, §Êt níc

Th¸ng

N¨m

Th¸ng

N¨m

LÜnh vùc ®µo t¹o

B»ng cÊp

C¸c ch¬ng tr×nh ®µo t¹o kh¸c

Thêi gian ®µo t¹o

Tõ

§Õn

Tªn trêng, Thµnh phè, §Êt níc

Th¸ng

N¨m

Th¸ng

N¨m

LÜnh vùc ®µo t¹o

B»ng cÊp, Chøng chØ

C¸c lÜnh vùc tr×nh ®é chuyªn m«n (VD: KÕ to¸n, Th ký, LuËt, Ng©n hµng, Kü s...)

C¸c chuyªn m«n kh¸c trong viÖc lÜnh vùc qu¶n lý, kinh doanh, tµi chÝnh, hoÆc lÜnh vùc kh¸c (Ghi cô thÓ. Cã thÓ ghi thªm vµo tê riªng)

Thµnh viªn trong c¸c tæ chøc ho¹t ®éng x· héi, céng ®ång hoÆc c¸c tæ chøc níc ngoµi

LiÖt kª nh÷ng bµi b¸o, s¸ch, hoÆc c«ng tr×nh anh/chÞ ®· tõng tham gia (Kh«ng cÇn ®Ýnh kÌm)

LiÖt kª nh÷ng phÇn mÒm m¸y tÝnh anh/chÞ quen sö dông. Nãi râ tr×nh ®é sö dông (VD: KÐm, Trung b×nh, Tèt )

Tèt

Kh¸

TB×nh

KÐ

Tríc ®©y anh/chÞ ®· göi ®¬n xin viÖc tíi GAMI cha? NÕu "Cã", ®Ò râ thêi gian vµ v

Cã/kh«ng

Thêi gian (th¸ng, n¨m)

VÞ trÝ

Anh/ChÞ ®· tõng lµm viÖc cho GAMI cha? (thêng xuyªn, t vÊn, hîp ®ång hay t¹m thêi)

NÕu "Cã", cung cÊp ®Çy ®ñ chi tiÕt trong phÇn Qu¸ trinh lµm viÖc díi ®©y.

Cã

Kh«ng

Qu¸ tr×nh lµm viÖc: (B¾t ®Çu tõ c«ng viÖc hiÖn t¹i/gÇn ®©y nhÊt, ghi tõng c«ng viÖc anh/chÞ ®· lµm vµo mçi «. KÓ c¶ thêi gian lµm nghÜa vô qu

Cã thÓ kÌm thªm giÊy cã mÉu gièng díi ®©y)

Tõ

§Õn

Møc l¬ng hµng n¨m

Chøc vô/VÞ trÝ lµm viÖc

Ngµy

Th¸ng

N¨m

Ngµy

Th¸ng

N¨m

Khëi ®iÓm

GÇn ®©y nhÊt

Tªn vµ chøc vô cña ngêi gi¸m s¸t

Thµnh tÝch ®¹t ®îc:

Sè lîng&c«ng viÖc cña NL§ mµ anh/

Tªn vµ ®Þa chØ c¬ quan

Lý do nghØ viÖc

LÜnh vùc ho¹t ®éng

Sè ®iÖn tho¹i

M« t¶ c«ng viÖc:

Tõ

§Õn

Møc l¬ng hµng n¨m

Chøc vô/VÞ trÝ lµm viÖc

Ngµy

Th¸ng

N¨m

Ngµy

Th¸ng

N¨m

Khëi ®iÓm

GÇn ®©y nhÊt

Tªn vµ chøc vô cña ngêi gi¸m s¸t

Thµnh tÝch ®¹t ®îc:

Sè lîng&c«ng viÖc cña NL§ anh/chÞ

Tªn vµ ®Þa chØ c¬ quan

Lý do nghØ viÖc

LÜnh vùc ho¹t ®éng

Sè ®iÖn tho¹i

M« t¶ c«ng viÖc:

Tõ

§Õn

Møc l¬ng hµng n¨m

Chøc vô/VÞ trÝ lµm viÖc

Ngµy

Th¸ng

N¨m

Ngµy

Th¸ng

N¨m

Khëi ®iÓm

GÇn ®©y nhÊt

Tªn vµ chøc vô cña ngêi gi¸m s¸t

Thµnh tÝch ®¹t ®îc:

Sè lîng&c«ng viÖc cña NL§ anh/ch

Tªn vµ ®Þa chØ c¬ quan

Lý do nghØ viÖc

LÜnh vùc ho¹t ®éng

Sè ®iÖn tho¹i

M« t¶ c«ng viÖc:

Chóng t«i cã thÓ liªn hÖ víi gi¸m ®èc n¬i anh/chÞ ®ang lµm hiÖn nay ®îc kh«ng?

Cã

Kh«ng

NÕu cã, thêi ®iÓm nµo phï hîp?

NÕu kh«ng, v× sao?

Ngßi chøng nhËn: Ghi tªn 03 ngêi, kh«ng cã quan hÖ hä hµng víi anh/chÞ, biÕt râ tÝnh c¸ch, tr×nh ®é chuyªn m«n vµ n¨ng lùc cña anh/chÞ mµ G

Hä vµ tªn, NghÒ nghiÖp

§Þa chØ/®iÖn tho¹i/E-mail/Fax

LÜnh vùc ho¹t ®éng

Anh/ChÞ cã bÞ m¾c c¸c bÖnh nguy hiÓm nµo kh«ng?

Cã

Kh«ng

Nªu cô thÓ nÕu "Cã"

Anh/ChÞ ®· tõng m¾c tiÒn ¸n, tiÒn sù, nghiÖm hót, ma tuý, cê b¹c kh«ng?

Cã

Kh«ng

Nªu cô thÓ nÕu "Cã"

Anh/ChÞ cã thÓ vµ s½n sµng ®i c«ng t¸c?

N¬i c«ng t¸c anh chÞ cã thÓ dÕn

Cã

Kh«ng

MiÒn b¾c

MiÒn T

MiÒn N

BÊt cø ®©

Dµi h¹n

Ng¾n h¹n <6 th¸ng

Anh/ChÞ ®· tõng bÞ sa th¶i hoÆc ph¶i tõ chøc cha?

Cã

Cha

Nªu cô thÓ nÕu "Cã"

Anh/ChÞ cã thÓ cho biÕt møc thu nhËp mµ anh/chÞ mong muèn?

mçi th¸ng

Anh/ChÞ mong muèn GAMI mang ®Õn cho b¹n ®iÒu g× ngoµi møc thu nhËp trªn?

NÕu anh/chÞ ®îc tuyÓn dông, khi nµo anh/chÞ cã thÓ b¾t ®Çu c«ng viÖc (tÝnh tõ ngµy h«m nay)?

Ngay lËp tøc

TuÇn

Kh¸c (Ghi cô thÓ)

T«i xin cam ®oan nh÷ng th«ng tin cung cÊp trªn ®©y lµ chÝnh x¸c vµ ®Çy ®ñ. T«i chÊp nhËn viÖc ®iÒu tra, thÈm tra ®èi víi nh÷ng th«ng tin vÒ c¸

søc khoÎ hoÆc c¸c vÊn ®Ò liªn quan kh¸c cÇn trong qu¸ tr×nh GAMI ra quyÕt ®Þnh tuyÓn dông, vµ chÊp nhËp bÞ sa th¶i nÕu nh÷ng th«ng tin trªn

Ngµy

Ch÷ ký

PhÇn ghi cña GAMI GROUP

§iÓm sè

XÕp lo¹i

§iÓm kiÓm tra viÕt

§¸nh gi¸ (®iÓm)

PhÇn pháng vÊn

Tr×nh ®é chuyªn m«n tuyÓn dông

Kh¶ n¨ng vµ kinh nghiÖm chuyªn m«n

Ngo¹i h×nh vµ giao tiÕp

S¸ng t¹o trong c«ng viÖc

Kh¶ n¨ng lµm viÖc ®éc lËp vµ hÖ thè

Hîp t¸c vµ thiÖn

(ghi chó:: ®iÓm 1 lµ: kÐm, 2: yÕu, 3: trung

Tæng ®iÓm

XÕp lo¹i

KÕt luËn

§Ò nghÞ tuyÓn dông

Tõ chèi tuyÓn dông

§Ò nghÞ thi tuyÓn vµo vÞ trÝ kh¸c

VÞ trÝ tuyÓn dông

Møc l¬ng khëi ®i

Héi ®ång tuyÓn dông (ký, ghi râ

Ngµy

Ch÷ ký 1

Ch÷ ký 2

Ch÷ ký 3

Ban Tæng gi¸m ®èc phª duyÖt

VÞ trÝ tuyÓn dông

Møc l¬ng khëi ®iÓm

Ngµy

Ch÷ ký

.

Applicant ID No.

ASIAN DEVELOPMENT BANK

chedrb

P.O. BOX 789, 0980 Manila

PHILIPPINES

To:

Celia R. Baltao/OAS/ADB@ADB

cc:

Telephone (63-2) 632-4444

Fax (63-2) 636-2526; (63-2) 636-2444

Website: http://www.adb.org

E-

Affix Recent

Subject:

Unified Personal History Form -- Additional item

PERSONAL HISTORY FORM

Passport Size Photo

Ched:

Again, thank you for your suggestion.

Please type or print your answer to each question clearly and comletely.

Read and follow carefully all the directions given.

Here are the following information for your incorporation in the final form.

Do not write in shaded areas.

The maximum validity period for a Personal History Form is two(2) years from date of receipt.

Website:

www.adb.org

Appointments to the staff of ADB will be valid only after you passed the prescribed medical examinations.

Emails:

[email protected] for Professional Staff and Young Professional applications

[email protected] for Support Staff applications.

Have a nice weekend.

Family Name (Last name)

First Name

Middle Name

Mary Anne

Permanent Address (City/State/Country)

Telephone Numbers

Home

Zip Code

Other

Contact Address (City/State/Country)

Phone

Fax

Zip Code

E-mail

Validity Dates for Contact:

YYYY

From

Gender

Height

Weight

Civil Status

(cm.)

(Kg.)

Single

Married

Other (Please specify)

Date of Birth

Place of Birth

10.

Citizenship

YYYY

11.

Family Members: (Spouse, Children, Parents, Parents-in-Law)

Date of Birth

Name (Family Name, First Name)

Relationship

YYYY

12.

If you have a spouse, specify his/her current occupation.

13.

Name of person to be notified in case of emergency

10.

Telephone Number

Complete Address

14.

Have you obtained legal/permament residence status

15.

Have you any relative in Asian Development Bank

16.

Job Position preference

in any country other than that of your citizenship?

or other similar international organization?

Yes

1st

If "Yes" which country and when?

If "Yes" give name, relationship and organization:

2nd

3rd

ADB Form No. 380/00

March 2001

17.

Beginning with your native language, enter all languages you know. Please indicate your proficiency by marking the appropriate box.

Language

Reading

Writing

Speaking

Understanding

Good

Fair

Slight

Good

Fair

Slight

Good

Fair

Slight

Good

Fair

Slight

18.

EDUCATION: (Please give full details)

Schools or other formal training or education from age 14 (e.g. High School, technical school or apprenticeship)

Period of Attendance

From

Certificates, Awards or

Name, City and Country

YYYY

Main Course of Study

Distinctions Received

University or Equivalent

Period of Attendance

From

Diploma/Degrees

Name, City and Country

YYYY

Main Course of Study

Equivalent

Part-time Study Program

Period of Attendance

From

Degrees and Academic

Name, City and Country

YYYY

Main Course of Study

Distinctions Obtained

Professional qualifications or specialized training (e.g. Certified Public Accountant, Chartered Secretary, Bar Admission, Banking, Engineering, etc.)

19.

Other special qualifications in financial, development, or planning institutions. (Please give details. Use separate sheet, if necessary)

20.

Membership in professional societies and activities in civic, public, or international affairs.

21.

List significant publications you have written. (Do not attach)

22.

List all computer softwares which you are familiar with. Indicate your proficiency (i.e. "L" for low; "A" for average; "H" for High)

23.

Have you previously submitted an application in ADB? If "Yes", indicate date.

Yes

YYYY

24.

Have you ever been employed by ADB (regular, consultant, contractual or temporary)?

If so, please provide details in your Employment Record in item below.

Yes

25.

EMPLOYMENT RECORD: (Starting with your present/latest job, list evry job you have had. Use a separate block for each job. Include also service

in the armed forces and periods during which you were not gainfully employed. If you need more space, atatch additional pages of the same size.)

From

Annual Salary

Position/Job Title:

YYYY

Starting

Latest

Name and Position of Supervisor:

Others (e.g. Bonuses, etc.)

Number and Category of Employees you Supervised:

Name and Address of Organization:

Reason for Leaving/Wanting to Leave:

Nature of Business:

Telephone No.

Describe your Work:

From

Annual Salary

Position/Job Title:

YYYY

Starting

Latest

Name and Position of Supervisor:

Others (e.g. Bonuses, etc.)

No. and Category of Employees you Supervised:

Name and Address of Organization:

Reason for Leaving/Wanting to Leave:

Nature of Business:

Telephone No.

Describe your Work:

From

Annual Salary

Position/Job Title:

YYYY

Starting

Latest

Name and Position of Supervisor:

Others (e.g. Bonuses, etc.)

No. and Category of Employees you Supervised:

Name and Address of Organization:

Reason for Leaving/Wanting to Leave:

Nature of Business:

Telephone No.

Describe your Work:

- If you have had more than four jobs, attach additional pages to record them -

From

Annual Salary

Position/Job Title:

YYYY

Starting

Latest

Name and Position of Supervisor:

Others (e.g. Bonuses, etc.)

No. and Category of Employees you Supervised:

Name and Address of Organization:

Reason for Leaving/Wanting to Leave:

Nature of Business:

Telephone No.

Describe your Work:

26.

State any other relevant facts. Include International experience, stating place and duration.

27.

Have you any objections to our making inquiries with your present employer?

Yes

If yes, why?

28.

REFERENCES: List three persons, not related to you, who are familiar with your character, qualifications and competence whom ADB may contact at any time.

Do not repeat names of the supervisor(s) listed under item 25.

Full Name and Job Title

Full Address / E-mail / Fax

Name of Business

29.

Do you have physical defects or disabilities?

Yes

If "Yes", please specify:

30.

Have you ever suffered from any serious nervous disorders or contagious diseases?

Yes

If "Yes", give details.

31.

Are you physically able and willing to travel?

Yes

By Air?

Yes

Frequently

Occassionally

32.

Have you ever been arrested, indicted or summoned into court as defendant in a criminal proceeding or convicted, fined or imprisoned for the violation of any law

(excluding minor traffic violations)?

Yes

33.

Have you ever been discharged or forced to resign from any position?

Yes

If "Yes", give details:

34.

What approximate starting salary will be acceptable to you for the position you have in mind? (Professional staff are paid in US dollars. Local recuits are paid in local currency.)

per month

35.

If your services are required at the earliest possible time, how soon will you be available to start work after being found suitable and physically fit for employment?

Immediately

Week's Time

Other (Please specify)

36.

I certify that the statements made by me in answer to the foregoing questions are true, complete and correct to the best of my knowledge and belief. Permission is given to

ADB to make such investigations as are necessary on the information given above. I understand that any misrepresentation or material omission made herein or in any

other document requested by ADB renders a staff member liable to termination of service or dismissal.

Date:

Signature:

N.B.

You will be requested to supply documentation evidence which supports the statements you have made above. Do not, however, send any documentary evidence until you have

been asked to do so by ADB, and in any event, do not submit the original texts of reference or testimonials or publications unless they have been obtained for the sole use of ADB.

ADB Form No. 380/00

March 2001