Biodata in Excel Form - DOC by tzn76588

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									        Photo                                                        RQS Candidate No._______________




        RETURN and REINTEGRATION OF QUALIFIED SUDANESE
                     Application for Participation
 Instructions: To apply for participation in the RQS Programme, please complete all questions and sections of
this form and submit it to the IOM office in your country of residence, or to IOM Sudan, with a photo, letter of
 interest, Curriculum Vitae, copies of your educational certificates, and reference letters from two employers.
              IOM Sudan Block 11 OE Amarat St. 47 House 18, PO Box 8322, Khartoum, Sudan
            (Tel) 249-183-570-80/1/2/3/4        (Fax) 249-183-569-09      ( Email) rqsskills@iom.int

1. BIODATA

i) Name: ____________________________                       Sex (F/M) _____           Age: ______
     (Family name, Given names)

ii) Marital status (circle):    Married.          Single              Divorced            Widowed

iii) Number of children:______

iv) Family size (no. of family members living together): ____________________________

v) Current Address: Location/settlement:________________Street:___________________

    City/Town:___________________________                   State/Country_____________________

vi) Contact Information (personal or within access) :

Tel:______________________                 Mobile _____________________

vii) How did you learn of the IOM RQS program: (circle)

IOM Office               Advertisement (radio, newspaper, Listserv, Internet)

Friend/Colleague         Family Member             Employer          Other_________________

2   ORIGIN

i) Place of origin: State:_____________________ Locality/County___________________

    Rural council/Payam_______________________Village (settlement):_________________

ii) How many years have you lived in current location (place of displacement)?
    ___________________

                                                                                                   Page 1 of 4
3   EDUCATION

i) Highest level of education completed (circle)       Primary School Certificate

Secondary School Certificate           Diploma         Bachelor's Degree      Master's Degree

PhD            MD              MD with Specialisation


ii) Name of the Last School/Institute/College/University: ______________________________

iii) Location of Last School/Institute/College/University: ______________________________
     (city/state and country)

iv) Number of years in the school/Institute/College/University: _______________

v) Year/Date of qualification: /______/____/_____/


vi) Languages of Fluency (circle)      English         Arabic           Other__________________


vi) Computer Skills (circle) Word              Excel Powerpoint         Other __________________


vii) Certificate available (circle): Yes (attach a copy)          No (why?_________________)


4   VOCATION/PROFESSION

i) Vocational or Professional Area (circle):

Health         Education       Communications/ Media            Information Technology

Law/Governance/Judiciary       Engineering/Infrastructure       Agriculture/Natural Resources

Water/ Sanitation      Rural/ Community Development             Finance/Banking

Business Services      Industry/Manufacturing                   Trade

Other ___________________________

ii) Area of Concentration or Specialisation ____________________________________

iii) Vocational or Professional Function (circle):

Management             Administration            Technical              Support

Other __________________________


                                                                                         Page 2 of 4
5 EMPLOYMENT

i) Number of years of formal employment in field ______________

ii) Number of years of informal or self-employment in field ____________


iii) Current employment Status (circle): Full-Time Staff Full-Time Contract/Temporary,

Part-Time Staff       Part-Time Contract/Temporary            Daily/Hourly Basis

Self-Employed         Unemployed


iv) Sector of employment, current or last held (circle):

Government                   Private                 local non-governmental

international non-governmental                 Self-Employ


v) Current or last employer: Location ____________________

Name of employing office/company:___________________________

Contacts of employer: Tel:______________________ E-mail: _____________

Address __________________________________________________________


vi) If self employed, Type of self-employment (circle):

Trade Consultancy Service              Production    Other _______

vii) Location of Self-employment ____________________


6 INTENTION TO RETURN

i) Are you willing to return? (circle):       Yes     No        Not decided


ii) To what destination do you want to return (circle):

State____________________County ____________________               Payam________________


iii) When are you ready to return (circle)?

Within 3 months      Within 6 months          Within 1 year        After 1 year

                                                                                   Page 3 of 4
iv) Number of family members who will return with you: ____________

(Please list names, relationship and ages below)
Name                              Relationship                     Date of Birth




v) Number of family who will return within one year of your return_________
(Please list names, relationship and ages below)
Name                              Relationship              Date of Birth




vi) Number of family who will not return within one year of your return __________


vii) For how long do you intend to return (circle):

Permanently           Long-term (more than 1 year)

Temporarily (1- 6 months year commitment)             Short-term (less than 6 months)

Undecided


6. DECLARATION
□ I hereby confirm and declare that the information given above is true to the best of my
   knowledge;

□ I hereby confirm and declare that if I accept to return to Sudan with RQS Programme
  assistance, that I intend to present myself for employment as agreed prior to my return;

□ I, the undersigned, declare that, after due consideration and entirely of my own free will, I
  hereby voluntarily and freely request IOM’s assistance to travel to the state of intended
  destination in Sudan.


  Name: __________________Signature:________________Date:__________________


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