Tan Sri Hasmy Agam

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JOB APPLICATION FORM
Position Applied For
Photo (optional)
Personal Data
First Name(s) (underline the one normally used): Last Name/Surname ( in Capital Letters):
Maiden name (if any):
Place of Birth ( City, Country):
Date of Birth:
Nationality(ies) ( Present/Previous):
Optional :
Sex
Female
Male
Marital status
Single
Child(ren)
Yes
Married
Divorced/ Separated
No
Permanent Address:
Correspondence Address ( if different) :
Phone Number:
:
Mobile Number:
:
Email Address:
:
Education and Training (University Degree, Postgraduate Studies, Language or IT Courses, Specific
66/2 Pan Road, Silom, Bang Rak, Thailand
Tel: +66 (0)2 6379126-7 Fax: +66 (0)2 6379128, Email: info@forum-asia.org, Webpage: http://www.forum-asia.org
Skills Workshops/Diploma)
Dates
Name/Address of Institution or
Course Provider
Details of Course
Qualifications
Attended
Gained
From:
To:
From:
To:
From:
To:
From:
To:
From:
To:
From:
To:
Note (if any):
Publication(s) (if any)
Professional Experience
66/2 Pan Road, Silom, Bang Rak, Thailand
Tel: +66 (0)2 6379126-7 Fax: +66 (0)2 6379128, Email: info@forum-asia.org, Webpage: http://www.forum-asia.org
(Starting with the most recent, list IN REVERSE ORDER. Please describe any previous experience
(including Internships) you have had, giving full details of your duties.)
1. Name of Employer:
Address of Employer:
Name of Business:
Name/Position of Supervisor:
Contact Details:
Brief Description of Your Duties:
Exact Title of Your Position:
Period of Employment from:
2. Name of Employer:
Address of Employer:
till:
Name of Business:
Name/Position of Supervisor:
Contact Details:
Brief Description of Your Duties:
Exact Title of Your Position:
Period of Employment from:
3. Name of Employer:
Address of Employer:
till:
Name of Business:
Name/Position of Supervisor:
Contact Details:
Brief Description of Your Duties:
Exact Title of Your Position:
Period of Employment from:
4. Name of Employer:
Address of Employer:
till:
Name of Business:
Name/Position of Supervisor:
Contact Details:
Brief Description of Your Duties:
Exact Title of Your Position:
Period of Employment from:
till:
Please feel free to add more columns if you have more experience to be stated.
Other Skills
Languages (Please indicate your mother tongue and also level of proficiency: Fluent, Good, Intermediate,
66/2 Pan Road, Silom, Bang Rak, Thailand
Tel: +66 (0)2 6379126-7 Fax: +66 (0)2 6379128, Email: info@forum-asia.org, Webpage: http://www.forum-asia.org
Basic)
Language
Understand
Read
Write
Speak
IT skills (Please indicate Level of expertise in programme(s) or specific system(s))
References
Name/Title of Reference:
Name of Reference:
Relationship with the reference (current
employer):
Contact Address:
Phone Number:
Email Address:
When may we contact the person?
Contact Address:
Phone Number:
Email Address:
When may we contact the person?
(Before or after short listing):
(Before or after short listing):
Other Information
Please tell us more about yourself (e.g. hobbies and participation in social activities) and relate also your
working or extra-curricular experience to the job descriptions. Moreover, tell us how your abilities fit into
our requirements and why are you interested in this position.
If appointed, when can you start? Please state clearly.
66/2 Pan Road, Silom, Bang Rak, Thailand
Tel: +66 (0)2 6379126-7 Fax: +66 (0)2 6379128, Email: info@forum-asia.org, Webpage: http://www.forum-asia.org
I certify that the statements made by me in answer to the foregoing questions are true, complete and
correct to the best of my knowledge and belief.
Signature:
Date:
Please return/e-mail complete form to
applications@forum-asia.org
Office Address:
Asian Forum for Human Rights and Development (FORUM-ASIA)
66/2 Pan Road, Silom, Bang Rak, Bangkok 10500 Thailand
Tel: +66 2 6379216-7, Fax: +66 2 6379218
E-mail: info@forum-asia.org
66/2 Pan Road, Silom, Bang Rak, Thailand
Tel: +66 (0)2 6379126-7 Fax: +66 (0)2 6379128, Email: info@forum-asia.org, Webpage: http://www.forum-asia.org
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