04 February 2012 Home    

 
 
  *Required fields GENERAL QUESTIONNAIRE Html file Format Printable format Pdf File Format    
PERSONAL INFOMATION
Surname
First name
*Sex Male Female  
Number of dependants (If any)
Date of birth (Year)            
*Place of birth
*Citizenship at birth
      
*Present citizenship
      
*Country of origin
      
*Present country of residence
      
Since(Date)
Total years abroad
*How would you like to be contacted? (Check the appropriate boxes)
Address (Street, town, postal/zip code, country)

     
Telephone number
Mobile phone
Fax
E-mail
I prefer not to be contacted at this time (Respondents who choose this option are encouraged to contact IOM Addis if this changes at any time)    
PROFESSIONAL QUALIFICATIONS AND PRESENT OCCUPATION    
*Education    
  Highest qualification obtained    

Field of study


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multi-Selection

   
Other, please specify

   
Additional fields of study    

* Present Occupation
(Choose one or more from the list)


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multi-Selection

      
Other, please specify

     
Years of work experience
Are you interested to participate in this program? Yes No
How would you like to participate (Choose one or more from the list)
Virtual (This entails knowledge transfer through virtual conferencing, E-mails and/or on-line distance education)
One time mission (A one time visit designed to complete a specific project)
Sequenced/Repeated visits
Permanent return
Investment
When are you available to start (Check the appropriate box)
Immediately
Within three months
Within one year
Other (Please specify)
     
*Do you want to work in Africa? Yes No  
*If yes, your interest in working in Ethiopia is High Low    
Other African countries you would like to work in (List in order of priority)  
First choice    
Second choice    
Third choice    
   
Do you belong to any diaspora networks? Yes No  
Please specify

     
How did you hear about us      
Please specify

     
*Disclaimer:
I declare that the information provided can be shared with MIDA partner organizations
without disclosure of personal contact information such as Name, Address and Phone number etc.        
with personal contact information    
Thank you for taking the time to complete this questionnaire. Please feel free to include any comments you have that could improve this questionnaire and the MIDA program more generally by going to our feedback form.    
  Please attach your CV (Optional) - Browse your CV and Click Upload
CV file name
Upload your CV
   
 

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