Acd Biographical - Data - Form
Acd Biographical - Data - Form
: TSD/CON-02
979/69 SM Tower 24th Floor, Paholyothin Road,
Samsen Nai Phayathai, Bangkok 10400 Revised 3 /07/2001
Tel: +66 (0) 2 298 0681 to 92
Fax: +66 (0) 2 298 0012
E-mail: [email protected] URL: http://www.adpc.net
Note to Consultants: Consultants are asked to complete this form in addition to the curriculum vitae (CV). This data
sheet is supplemental to your CV – ADPC uses the information as a ready reference to assist in consultant selection
purposes only. The full CV is submitted to organizations outside ADPC, in relation to specific requests for
consultancy work. Please submit the completed form to the Technical Services Division of ADPC. Please word
process or, if writing by hand, write legibly. Thank you.
1. PERSONAL INFORMATION
Name (in full): Nationality: Date of Birth:
(d/m/y)
Home Address:
Office Address :
Mobile Phone No: Should mention Home Tel. No.: Should mention E-mail:
country code and area code country code and area code
3. EMPLOYMENT HISTORY
Please show your employment history for at least the last 5 years, and at least the last 3 employers. (please use
additional sheet if necessary)
DATE OF MONTHL
POSITION EMPLOYER’S NAME EMPLOYER’S ADDRESS EMPLOYMENT Y
From - To SALARY
(in US $)
4. CONSULTANCY HISTORY
Please show details for your last 3 consultancies. Your CV should show details of these and all others. (please use
additional sheet if necessary)
TYPES OF DATES DAILY
COUNTRIES
CLIENT’S NAME CLIENT’S SERVICES PERFORMED RATE
COVERED
COUNTRY & PERFORMED From - To (in US $)
CITY
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5. LANGUAGE PROFICIENCY (please check appropriately)
READ WRITE SPEAK
LANGUAGE
VERY VERY VERY
FAIR GOOD FAIR GOOD FAIR GOOD
GOOD GOOD GOOD
7. CERTIFICATION:
I certify that all the above given information in my application is true, complete and correct. I understand that if I have
misrepresented, given any false statement or deliberately hidden or withheld any required information or facts on this
application and been subsequently offered a job or employed, it will be grounds for the withdrawal of any offer of
appointment or immediate termination of my employment with ADPC. I further authorize ADPC to check all personal
and employment references and to verify all information I have provided in this application.
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