Photograph

(if not already submitted)

For the post of:______

Personal Details

Surname:______

Maiden name:______

First name:______

Date and place of birth:______

Nationality:______

Post code and town/city:______

Street and house number:______

Contact details

Telephone/fax:______

E-mail:______

Marital status/children:______

Health

Are you suffering from any condition

which may affect your ability

to perform the duties of the post

for which you are applying?______

Do you consider yourself

to have a disability or are you

registered disabled?______

If yes, to what extent:______

Education and Employment

(Please provide complete details)

School education[*]:

From month/year / To month/year / Type of school / Type of qualification and results

College/

University

From month/yearFrom month/year / To month/year / College/university, location / Field of study/qualification/degree/doctorate

Practical

training

From month/year / To month/year / Form of training
(e.g. apprenticeship, internship etc.) / Qualification (e.g. skilled worker’s certificate, certificate of apprenticeship, master craftsman’s diploma)

Employment history:

(including secondary employment)

From month/year / To month/year / Company/sector / Job title/description

(In the event of periods of employment being spent abroad, please specify these separately and name the country)

Foreign

languages:

Language / Ability / 4 =(as though) mother tongue
3 =problem-free participation in technical
discussions, accurate preparation of documents
2 =good understanding of written texts, ability to conduct simple conversations
1 =limited understanding of written texts and limited oral ability, knowledge acquired at school

Other

qualifications/

certifications:

(IT skills or other professionally useful skills)

______

______

______

______

______

______

General:

Do you have a driving licence?______Class: ______

Are you currently employed?______

If yes, have you already handed in

your notice? ______

How much notice do you have to give?______

Earliest possible starting date:______

What is your current annual salary (gross)?€______

What are your annual wage/salary

expectations (gross)?€______

Which insurance scheme do you

currently belong to?______

Are there any permanent assignments

and/or attachments of salary?______

Have you pledged or already

transferred your payments?______

Do you have any previous convictions

which could be relevant to

the job for which you have applied? ______

If yes, please specify:______

Do you have any entries in the …

central register of traffic offenders?______

Are you subject to any

restraints on competition?______

If yes, please specify the details

of the restraint:______

These details are complete and correct.

Place: ______, Date: ______

Signature

The information on this personnel form will be treated with the strictest confidentiality in accordance with the data protection law. The information will only be saved for future use in the event of appointment or registration and with your agreement.

[*]If not already sent, please attach a copy of your leaving certificate/your employee’s certificates (your degree/doctorate certificate).