APPLICATION FORM

Photo
(VOLUNTARY, FILLED WITH OWN HAND)

Position you apply for : ________________________________________

Agency/recommendation or reference:____________________________
Please enclose copies of your
1. ID papers and Medical insurance
2. Diplomas/certificates

1. Last Name (Surname), First Name and Patronymic:

______________________________________________________________________________________

2. If you changed your Surname, please tell us for what reason:

______________________________________________________________________________________

3. Date of Birth (Day, Month, Year):__________________________________________________________

4. Place of Birth: ________________________________________________________________________

5. Nationality: __________________________________________________________________________

6. Home Address (please specify Postal index, nearest Metro station):

а) Address of actual residing _______________________________________________________________

______________________________________________________________________________________

b) Address of registration (constant, temporary) ___________________________________________________

______________________________________________________________________________________

c) Phone numbers:

Home__________________ Mobile_________________ E-mail______________________________

d) Please, tell us how much time it takes you to get from home to work_________________________________

7. Have you ever worked abroad?

______________________________________________________________________________________

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8. Education (please specify all levels and kinds of education: secondary, higher, advanced training courses)

Speciality,
Name of educational institution and its site, faculty or branch, form of
Month-Year qualification under
education (internal or by correspondence)
the diploma
Entrance Gradua-
tion Basic

Advanced training courses

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9. Professional Experience (specify the country if you worked abroad):
Position,
Month-Year Work location
Functions, Reasons for
Entrance Gradua- (Name and field of activity of the Company, address and
Official Dismissal
tion phone number)
responsibilities

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10. Please inform us of your monthly average salary:
At the latest place of employment______________________, your wish____________________________

11. Foreign Languages:

(Please specify 1- read and translate with a dictionary, make myself understood / 2- fluent)

 English ________________________  ___________________________________

 French ________________________  ___________________________________

 Russian________________________  ___________________________________

12. Computer skills:

(Please specify 1- debutant user / 2- advanced user)

 Windows XP_____________________  Outlook_________________________

 Word___________________________  Internet_________________________

 Excel___________________________  VOIP (MSN, Skype)_______________

13. Typing speed in Word (symbols /min): Eng. text __________, Fr. text _________, Rus. text__________
You can test your typing skills with www.typingtest.com and www.nabiraem.ru

14. Operational experience with office equipment Yes/No): Xerox________, Fax______, Phone station_______

15. Please tell us what your marital status is: __________________________________________________

16. Close relatives (father, mother, brothers, sisters and children), husband (wife), including former:

Place of Address
Relation Last name, First Day, Month, Year
employment, (registered and
degree name, Patronymic* and Place of birth
position actual)

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17. Additional data:

17.1. If you own a car, please specify its make and model

year__________________________________________________________________________________

17.2. Driving Licence (category)________________ Driver's experience _____________________________

17.3. Please inform us of your interests, hobbies, achievements

In the field of sports

 _________________________________________________________________________________

 _________________________________________________________________________________

 _________________________________________________________________________________

In other spheres

 _________________________________________________________________________________

 _________________________________________________________________________________

 _________________________________________________________________________________

 17.3.2. Do you smoke?  often  from time to time  never

 17.3.3. Do you drink alcohol?  often  from time to time  never

 17.3.4. Do you take drugs?  often  from time to time  never

17.4. Please tell us what specialized literatures have you read for last 3 years:

(Please specify the literature on speciality – author and title)

 _______________________________________________________________________________

 _______________________________________________________________________________

 _______________________________________________________________________________

(Please specify other literature of other speciality (NOT FICTION) - author and title)

 _______________________________________________________________________________

 _______________________________________________________________________________

 _______________________________________________________________________________

17.5. If you have ever been sentenced, please tell us when and under what clause

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

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17.6. Please tell us have you ever been suspected of a felony

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

18. Please estimate a level of development of your personal features by points according to the 10 - point scale:

Mobile 10 9 8 7 6 5 4 3 2 1 Sluggish

Sociable 10 9 8 7 6 5 4 3 2 1 Closed

Resolute 10 9 8 7 6 5 4 3 2 1 Irresolute

Disciplined 10 9 8 7 6 5 4 3 2 1 Unorganized

Quiet 10 9 8 7 6 5 4 3 2 1 Emotional

Independent 10 9 8 7 6 5 4 3 2 1 Dependent on group

Active 10 9 8 7 6 5 4 3 2 1 Passive

Attentive 10 9 8 7 6 5 4 3 2 1 Inattentive

Hardworking 10 9 8 7 6 5 4 3 2 1 Lazy

Responsible 10 9 8 7 6 5 4 3 2 1 Irresponsible

Frank 10 9 8 7 6 5 4 3 2 1 Reserved

All my answers are true and represent the facts; I agree to a corresponding verification:____________________
(Yes/No)

:_________________________________________
(Date, Signature)

S.Sidorov Amended 15.09.08

D. Arsseniev Edited and corrected 19.09.08