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Legal
Place of Birth *
Application FormCambodian Children's Fund
I. PERSONAL DATA
Family Name * Given Name *
Family Name(Khmer) * Given Name(Khmer) *
Gender * Title * Date of Birth
Nationality *
National ID/Passport No *
Permanent Address *
Contact Address *
Phone Number 1 * Phone Number 2
Fax Number 2Fax Number 1
II. DEPENDENT
Dependent Name * Relationship * Gender * Date Of BirthNational ID/ Passport No Occupation
Apply Position *Apply Vacancy *
Country *
Email Address1
Photo(4x6)
Expire
Email Address2
Expect Salary(USSD)
Result
III. EDUCATIONAL BACKGROUND
Education Type Education Center1.
Major
Result
Remark
From Month To Month
Remark
To MonthFrom MonthResult
Major
Education Center2.
Remark
To MonthFrom MonthResult
Major
Education Center3.
Remark
To MonthFrom MonthResult
Major
Education Center4.
Remark
To MonthFrom MonthResult
Major
Education Center5.
Remark
To MonthFrom Month
Major
Education Center6.
Remark
To MonthFrom MonthResult
Major
Education Center7.
Education Type
Education Type
Education Type
Education Type
Education Type
Education Type
IV. LANGUAGE
Writing *Language * Reading *Listening *Speaking *
V. WORK HISTORY
From Date1. To Date
Company/Organization Position
Supervisor Name Supervisor Phone
Duties
Leave Reason
Start Salary End Salary Other Benefit
2.
Leave Reason
Other BenefitEnd SalaryStart Salary
Duties
Supervisor PhoneSupervisor Name
PositionCompany/Organization
To DateFrom Date
From Date3.
Leave Reason
Other BenefitEnd SalaryStart Salary
Duties
Supervisor PhoneSupervisor Name
PositionCompany/Organization
To Date
From Date
Leave Reason
Other BenefitEnd SalaryStart Salary
Duties
Supervisor Name Supervisor Phone
PositionCompany/Organization
To Date4.
From Date
Leave Reason
Other BenefitEnd SalaryStart Salary
Duties
Supervisor PhoneSupervisor Name
PositionCompany/Organization
To Date5.
From Date
Leave Reason
Other BenefitEnd SalaryStart Salary
Duties
Supervisor PhoneSupervisor Name
PositionCompany/Organization
To Date6.
VI. REFERENCE
Name1. Position
Company/Organization Email
Phone No(2)Phone No(1)
Address
Company/Organization
Address
Phone No(2)
Phone No(1)
PositionName2.
Company/Organization
Address
Phone No(2)
Phone No(1)
PositionName3.
I certify that all data and infromation which I have provided above are true, complete, and correct to the best of my knowledge and belief. I understand that if any of the data and information and misrepresented or if there are data or information that were omitted, renders Plan staff liable to termination or dismissal.
Date: Print Name and Signature:
From Date
Leave Reason
Other BenefitEnd SalaryStart Salary
Duties
Supervisor PhoneSupervisor Name
PositionCompany/Organization
To Date7.
From Date
Leave Reason
Other BenefitEnd SalaryStart Salary
Duties
Supervisor PhoneSupervisor Name
PositionCompany/Organization
To Date8.
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