CONFIDENTIAL

Important
All the information in this questionnaire may be verified

Candidates history
1. Data
Name:
_________________________________________________________________________
(First) (Middle) (Family)

Present home address: __________________________________________________________

Zip code: __________________ City: _______________________State: __________________
Phone: Home:
_______________ Mobile: _______________ Business: _________ Ext:
_____
(check phone that we may use)

Nationality(ies): _____________________________ Place of birth:

_______________________
E-mail:
___________________________________ Marital status: ( ) single ( ) married
Date: ___/___/______

2. Education
School, college or University: ____________________________________________________
Qualification gained: ___________________________________________________________
(e.g., Master, Bacharel, M.B.A.,PhD)

Degree: ______________________________________________________________________
Dates attended: From:
To:
(MM/YY)

(MM/YY)

School, college or university: _____________________________________________________

Qualification gained: ____________________________________________________________
(e.g., Master, Bacharel, M.B.A.,PhD.)

Degree: _______________________________________________________________________
Dates attended: From:
To:
(MM/YY)

(MM/YY)

Scholarships/special honors:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
___

3. Work experience
Please give the following information concerning your work experience (last two positions). Use a separate
sheet for other previous employment

Name and address of employer: ___________________________________________________

Type of industry: _______________________________________________________________
Title of position: ________________________________________________________________
Date of employment: From:
To:
(MM/YY)

(MM/YY)

Name and address of employer: ___________________________________________________

Type of industry: _______________________________________________________________

Title of position: ________________________________________________________________
Date of employment: From:
To:
(MM/YY)

(MM/YY)

4. Extracurricular activities
Activities and offices help while at school, college or University:
Jr. Enterprise
Students council
Teaching assistant
Sports clubs
Office or nature of participation, dates and # of years:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
___
Relevant past and present memberships in clubs or business and professional
organizations:
Extent of activities, dates and # of years:

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
____
Communities activities, military service, others
Extent of activities, dates and # of years:

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
____

5. Deployment information
In which countries and for how long, have you resided?
______________________________________________________________________________
______________________________________________________________________________
__
Do you have any hobbies? If not, what do you do in your spare time?
______________________________________________________________________________
______________________________________________________________________________
__

Language ability
(check if stage I, II, III, IV, V or N)

Stage
I
English
Spanish
Portuguese

II

III

IV

Stage I: Capability of reading the language

accurately and of carrying on a simple
conversation
Stage II: Capability of interviewing an executive,
or being interviewed, with confidence on a faceto-face situation, but where speed of discussion
can be controlled, ability to make notes in the
foreign language

Stage III: Being fully in the picture and able to contribute constructively when amongst a group of
executives talking their national language
to each other; the ability to prepare with
fair accuracy relevant documents and
reports in the foreign language
Stage IV: Virtual native language ability, although it is not ones native language rapidly and
accurately
Stage N: Native language