Separate Application Form To Be Used For Different Posts
Separate Application Form To Be Used For Different Posts
Separate Application Form To Be Used For Different Posts
Rduit, Mauritius
Telephone: 401 6555
Fax: 454 10 37
Web Site: www.mieonline.org
APPLICATION FORM
(PLEASE COMPLETE THIS FORM IN 2 COPIES AND WRITE CLEARLY IN INK)
2.
3.
Title:
Mr
4.
Surname:
.......................................................................................................
Mrs
Miss
Block
Letters
..............................................................................
Residential Address:
.................................................................................................
E-mail Address:
6.
Mobile: .........................
Age:
Office: ........................
Nationality: ...............................
Education
Names of secondary schools attended: .................................................................................
SC/GCE O Level
1st attempt
2nd Attempt
3rd Attempt
Results
Date of Attempt (Month/Year)
Subjects
Grades (e.g. 1, 2, 3 ... or A, B, C ...)
1st attempt
HSC/GCE A Level
Results
Date of Attempt (Month/Year)
Subjects taken at Principal Level
3rd Attempt
7.
2nd Attempt
Institutions
Duration
From
To
1
2
3
4
5
8.
Employment History
(a)
From: To:.
Institution/Secondary School:...
Present Salary: ............................
(b)
Previous Employment
Name of Employer
Period
From
9.
Post held
To
Other courses, seminars, etc (if any) attended. (Give details, including dates)
.........................................................................................................................................................
.........................................................................................................................................................
.........................................................................................................................................................
.........................................................................................................................................................
10.
Indicate
a.
Any important articles, books, etc, which you have published or contributed to:
............................................................................................................................................
............................................................................................................................................
b.
Hobbies, sports, interests and any other matters you would wish to bring to the attention of the
Institute
............................................................................................................................................
............................................................................................................................................
............................................................................................................................................
11.
Referees
Referee 1
Referee 2
Name: ................................................................
Name: ................................................................
Occupation: .........................................................
Occupation: .........................................................
Address: ..............................................................
Address: ..............................................................
.............................................................................
.............................................................................
Declaration
I, ..........................................................................................................................................., the
undersigned applicant declare that the particulars in this application form are true and accurate and that I
have not willfully suppressed any material fact.
Date: ............................................
Signature: ................................................
NB: Incomplete and inaccurate filling of the form and not supported by relevant documents may entail
elimination of candidates.