. 3.1) Name of Nominee (as in the passport) Family Name First Name Middle Name 3.2) Nationality 3.5) Date of (please write out (as shown in the passport) the month in English as in “April”) 3.3) Sex ( ) Male ( ) Female Date Month Year Age 3.4) Religion 3.6) Present Position and Current Duties Organization Department / Division Present Position Date Month Year Date Month Year Date of employment by Date of assignment to the the present organization present position 3.7) Type of Organization ( ) National Governmental ( ) Local Governmental ( ) Public Enterprise ( ) Private (profit) ( ) NGO/Private (Non-profit) ( ) University ( ) Other ( ) 3.8) Outline of duties: Describe your current duties 9) Contact Information Address: Office TEL: Mobile (Cell Phone): FAX: E-mail: Address: Home TEL: Mobile (Cell Phone): FAX: E-mail: Name: Relationship to you: Contact person Address: in emergency TEL: Mobile (Cell Phone): FAX: E-mail: 3.10) Others (if necessary)
. 3.1) Name of Nominee (as in the passport) Family Name First Name Middle Name 3.2) Nationality (as shown in the passport) 3.5) Date of (please write out the month in English as in “April”) 3.3) Sex ( ) Male ( ) Female Date Month Year Age 3.4) Religion 3.6) Present Position and Current Duties Organization Department / Division Present Position Date of employment by the present organization Date Month Year Date of assignment to the present position Date Month Year 3.7) Type of Organization ( ) National Governmental ( ) Local Governmental ( ) Public Enterprise ( ) Private (profit) ( ) NGO/Private (Non-profit) ( ) University ( ) Other ( ) 3.8) Outline of duties: Describe your current duties 9) Contact Information Office Address: TEL: Mobile (Cell Phone): FAX: E-mail: Home Address: TEL: Mobile (Cell Phone): FAX: E-mail: Contact person in emergency Name: Relationship to you: Address: TEL: Mobile (Cell Phone): FAX: E-mail: 3.10) Others (if necessary)
training_y_1506.docx