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CURRICULUM VITAE
Local Agent
SURNAME: ___________________________________________________________________________
FORENAMES: ___________________________________________________________________________
MAIDEN NAME: ___________________________________________________________________________
DATE OF BIRTH : ___/___/____ PLACE OF BIRTH : _________________________________________
day month year country region/town
NATIONALITY AT BIRTH / _________PRESENT NATIONALITY _ ___________________________________
(if dual indicate both)
ADDRESS :_______________________________________________________________________________
Phone – Fax : _______________________________ E-mail : _____________________________________
SEX : (place a « X » in the appropriate square) : MARITAL STATUS (place a « X » in the appropriate square) :
MALE FEMALE SINGLE MARIED WIDOWED DIVORCED SEPARATED
( ( ( ( (( ( (
EDUCATION : (please give full details in the appropriate spaces below)
(A) Higher education (University or equivalent education and postgraduate education, if applicable) :
|Name of establishment |Years of study |Diplomas or degrees obtained |Main subjects studied |
| |from |and type of degree | |
| |to | | |
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(B) Education since the age of 12 (e.g secondary education, other education, technical training as apprentice, or equivalent training, to be specified under « category ») :
|Name |Category |Years of study |Diplomas or degree obtained |
| | |from | |
| | |to | |
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(C) Other formations related to the function (seminars, …) :
|Establishment |Title - Content |When (year) |
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SURNAME :__________________________________________ FORENAME : ______________________________________________
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PROFESSIONAL EXPERIENCE * :
|Dates : month and year |Type of position : |Employer : |Reasons for leaving : |
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|Last salary : |
KNOWLEDGE OF LANGUAGES :
|READING |WRITING |SPEAKING |
| |Excellent |Good |Fair |
|WORD | | | |
|EXCEL | | | |
|WINDOWS | | | |
|Other | | | |
| |Excellent |Bien |Moyen |
|Other | | | |
|Other | | | |
|Other | | | |
|Other | | | |
OTHER USEFULL KNOWLEDGE FOR THE PROPOSED FUNCTION :
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|Signature of the agent / candidate |Signature of the delegation, after control of the data |
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|Place Date |Place Date |