Applicant Information

Please attach
recent
passport-size
photograph
here

A. Professional
1. Position applying for:
2. Name:
3. Contact no. & email address:
4. Academic record (start with highest degree) [Add additional row(s), if necessary]:
#

Name of the Institution

Degree/ Level
(Please mention subject in
Honours & Masters level)

Passing
Year

Class/Division/
Grade

5a. Employment record (start with current job) [Add additional row(s), if necessary]:
#

Name of Organization

Duration
From
To

Designation

Reason for leaving

3-5 key responsibilities:

3-5 key responsibilities:

3-5 key responsibilities:

5b. Experience of voluntary work, if any [Add additional row(s), if necessary]:
#

Name of Organization

Duration
From
To

Designation

Reason for leaving

6. Total length of experience (total duration at 5a):

7. Your current/last drawn gross monthly salary (in Tk.):
8. Explain the reason(s) for gap in service (if more than three months):

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Applicant Information
9. Training Record [Add additional row(s), if necessary]:
#

Title/Subject of Training

Duration

Provided by

Location

10. Language skill [Add additional row(s), if necessary]:

Writing
#

Speaking

Language
Average

Very
Good

Good

Excellent

Average

Good

Very
Good

Excellent

11. Computer skill: Please specify by putting a cross (X) under appropriate program. List any other
program you are skilled in under the column Other.
MS
Word

MS
Excel

MS
PowerPoint

MS Access

SPSS

STATA

Other

12. Any other relevant special skills:

13. List of publication(s)/Report(s), (If any):
14. Any special achievement/distinction:

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Applicant Information
B. Personal
1. Full name:

6. Nationality:

2. Fathers name:

7. Religion:

3. Mothers name:

8. Ethnic identity:

4. Date of birth:

9. Disability (if applicable):

5. Sex:

10. Marital status:

11. List of immediate family members employed in TIB, if any [Add additional row(s), if necessary]:
#

Name of relative

Designation at TIB

Place of posting

12. In your professional career were you ever terminated on disciplinary ground? If yes, give details:
13. Were you ever convicted of a criminal offence? If yes, give details:
14. Address (including contact no. & email):
Permanent Address

Mailing Address

15. Reference (with full contact details and email):

Referee 1

Referee 2

16. Authentication:
a) Do you certify with full confidence that the information provided are authentic and accurate (put
X to indicate)?
Yes

No

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Applicant Information
b) Do you confirm that you have read the TIB Code of Ethics (http://www.ti-bangladesh.org/TIBCodeofEthics.pdf) and if appointed, do you agree to uphold it fully (put X to indicate)?
Yes

No

17. Signature: .......................................................................

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Date: ...................................

Printed on 16/11/2014 at 6:38 AM