Print Form

Midwest Assistance Program Inc.

Biodata Form
Please Attach Resume
A. Personal/Contact Information 1. Last Name: First Name: Middle Name: Primary Address Address: City: State/Province: Alabama Country: ZIP Code: Home Phone: Other Phone: Cell Fax: E-mail: Personal Web Site:

Secondary Address Address: City: State/Province: Alabama Country: Zip Code: Work

2. What type of assignment would you consider? (check all that apply) Short-term assignments Long-term assignments (greater than 1 year) Volunteer assignments 3. How did you hear about Midwest Assistance Program?

B.

Background Information Yes No

4. Are you a U.S. Citizen?

5. List countries where you have residency status 1. 2. 6. Are you a Midwest Assistance Program (MAP) board member, current or former employee or retiree? (check all that apply) MAP board member Current MAP employee Former MAP employee MAP retiree None of the above 7. Check each educational/certification level attained and write in your major area of study Technical Associates Bachelors of Arts or Science Masters Doctorate/Juris Doctorate Certifications. Please Identify

November, 2008

8. List languages in which you can communicate and indicate your ability level Language: Speak Read
Fluent Fluent Fluent Good Good Good Basic Basic Basic Fluent Fluent Fluent Good Good Good Basic Basic Basic Fluent Fluent Fluent

Write
Good Good Good Basic Basic Basic

C.

Experience

9. For each region below in which you have experience, check your years of experience range. Years of Experience Region < 2 years 2 4 years 5 10 years Northeast/Puerto Rico Central States Southeast Midwest/Plains Southwest West Coast/Alaska/Hawaii International 10. For each skill area below in which you have experience, check your years of experience range. (NOTE & CHECK: Applied = Practical Experience; Theoretical = Formal Education; Tribal = Experience; Training Competency = Experience as Trainer)
Training Competency

> 10 years

Skill Area

Skill Area

Agricultural Economics Agricultural Economist Agricultural Sector Planning Commodity Market Research/Price Forecasting Banking and Finance Accounting/Auditing Banking Credit Analysis Financial Analysis Financial Management Carbon Credit Market Knowledge Assessment/Certification Residential/Business Energy Audits Business/Finance Education Curriculum Development Drug Awareness Early Childhood Development Health Certified Nurse Assistant Elder Care/Aging Licensed Vocational Nurse

Market Information Systems Socio-Economist

Investment Analysis Loan Funds Microfinance Rural Credit

Residential/Business Energy Credits Trading Leadership Development Leadership Development Adults Leadership Development Youth Training General Nutrition & Health Policy Registered Nurse

November, 2008

Training Competency

Years of experience 5 10 years

Years of experience 5 10 years

2 4 years

2 4 years

Theoretical

Theoretical

> 10 years

> 10 years

< 2 years

< 2 years

Applied

Applied

Tribal

Tribal

Training Competency

Skill Area

Skill Area

Housing First Time Buyer Multifamily New Construction Inspection Infrastructure Asset Management Backflow Prevention Brownfields Budgeting/Rate Setting Capacity Assessment TMF Community Needs Assessment Community Planning Composting Comprehensive Performance Evaluation Construction Inspection Construction Management Consumer Confidence Reports Disaster/Debris Management District Development Wastewater District Development Water Emergency Planning Emergency Responder FEMA Training Engineering Financial Management HACCP Hiring an Engineer Law and Policy Advocacy Environmental Law/Policy Marketing Advertising/Promotion Brand Development Finished/Value Added Product Distribution Market Analysis/Research Natural Resources Ecotourism Environmental Mgmt/Assessment Land/Soil Conservation Natural Resources Mgmt/Assessment

New Construction Management Self Help Tax Credits Lagoon Operations & Management Landfill Inspector Leak Detection LMI/MHI Survey New EPA Rules Response Process Loan/Grant Application Records Management Recycling Management Risk Analysis Risk Mitigation Sanitary Surveys Solid Waste Audits Solid Waste Management Solid Waste Protection Utility Management Vulnerability Assessments Wastewater Collection Operation & Maintenance Wastewater Operator Wastewater Treatment Operation & Maintenance Water Loss Survey Water Operator Trade/Law Policy

Retail or Wholesale Sales Service Marketing Supply Chain Management

Pollution Prevention/Mitigation Solid Waste Management Water Sanitation Wetlands/Watershed Management

November, 2008

Training Competency

Years of experience 5 10 years

Years of experience 5 10 years

2 4 years

2 4 years

Theoretical

Theoretical

> 10 years

> 10 years

< 2 years

< 2 years

Applied

Applied

Tribal

Tribal

Natural Resources continued Administration Association Management Financial Association Management General Board Training Business Administration/Management Business Development Business Plan Development Bylaws Development Communications Conflict Resolution Customer Service Financial Fundraising Processing/Quality Assurance/Manufacturing GMP HACCP ISO Project Management Grants Management Project Administration/Management Rural Development and Civil Society Civil Engineering Civil Society Organization Management/Sustainability Community-based Organizations Conflict Management/Dispute Resolution Electrical/Power/Energy Gender Issues Immigrant Resettlement Safety & OSHA Compliance Chemical Construction Electrical Emergency Planning Emergency Response Technology Asset Management Broadband/Internet Computer Training Hiring Internet Service Provider

Human Resource Management Intuitional Capacity Building Leadership Development & Training Legal Microfinance/Microcredit Non-Profit Management Ordinances Community Process Facilitation Community Proposal Development Strategic Planning Team Facilitation Technical Writing

Packaging Post Harvest Handling Quality Assurance Procedures Project Evaluation/Design Proposal Writing Indigenous Peoples Rights Land Rights/Water Rights Municipality Strengthening Private Sector Development Public Services Telecommunications

Ergonomics Fire Safety General Safely Issues Hazard Communication

Management Information Systems Telecommunications Web Creation Web Management

November, 2008

Any Other Skills

11. Please list any volunteer services. Date from Date to Organization/Community

Description/What you did

12. Please use the space below to provide any additional comments.

November, 2008

Digital Signature

Date

Please attach your resume

Then e-mail form and resume to map@map-inc.org indicating Attention: Recruiter in the subject line or mail to Midwest Assistance Program, Inc. Attention: Recruiter P.O. Box 81 212 Lady Slipper Avenue NE New Prague, MN 56071

Thank you!
We greatly appreciate your effort in taking the time to complete and return this form.

November, 2008