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Recruitment Services - Pro English Jalan Mesjid 1 no. 2, Depok 16514 Tel: 021-32772221 Email: info.proenglish@yahoo.com Web: proenglishweb.com Please complete this form in blue (readable handwriting only) ABOUT YOU Full name: Present address and contact telephone number:

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.................................. Cell Phone: ........................................ Email address: Permanent address (if different from above):

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.................................. Cell Phone: ........................................ Place of Birth

Marital Status

Date of Birth

Children

Religion

What valid driving license do you hold? Name, address and telephone number of a permanent contact in case of emergency while you are on duties:

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.................................. Cell Phone: ........................................ EDUCATION AND PROFESSIONAL QUALIFICATIONS Last school attended:

Grad Year:

High school department:

College or University:

Grad Year:

Degrees & latest GPA:

Other Education Qualifications:

Application Form 2010 – Pro English (web: proenglishweb.com)

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English Course taken (please indicate level):

...................................................................................................................................... ...................................................................................................................................... ...................................................................................................................................... Describe in some detail your views on teaching English as a foreign language:

...................................................................................................................................... ...................................................................................................................................... ...................................................................................................................................... ...................................................................................................................................... ...................................................................................................................................... PREVIOUS EMPLOYMENT Employer:

Month and year:

Position held:

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YOU AND YOUR INTERESTS Interests (indicate where relevant whether your interest is active or passive, e.g. an interest in “food” could be that of a visitor to exotic restaurants or that of an amateur cook):

...................................................................................................................................... ...................................................................................................................................... ...................................................................................................................................... ...................................................................................................................................... Describe yourself in the words of a fair but not very friendly critic:

...................................................................................................................................... ...................................................................................................................................... ...................................................................................................................................... ...................................................................................................................................... High school & college organization (please indicate the position):

...................................................................................................................................... ...................................................................................................................................... ...................................................................................................................................... ...................................................................................................................................... Please sign below I, .........................................................(FULL NAME OF SIGNATORY IN BLOCK LETTERS) declare that the information given above is true and complete, that I am in good health, and I am willing to follow the recruitment selection process with full responsibility.

Signed:

Date:

Application Form 2010 – Pro English (web: proenglishweb.com)

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