Ref No.TUM/Forms/HRM/020
TECHNICAL UNIVERSITY OF MOMBASA
EMPLOYMENT INTERVIEW DATA FORM
(To Be Filled By Interview Candidate)
Position Applied For ....................................................... Grade ..... Ref. No.................................
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PART A:
PERSONAL DETAILS
Full Names ...................................................................................... ID/No. ..................................
(As Appearing in the National Identity Card)
Date of Birth ............................
Nationality .............................. Marital Status ....................
Contact Address:
Postal ............................................................................................................
Cell Phone ....................................................................................................
Email...............................................................................................................
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PART B:
(i) EDUCATIONAL & PROFESSIONAL QUALIFICATION
(In Descending Order of Ranking)
School/College Attended
Title
Course Tile
End
Year
Results
(ii) RELEVANT SEMINARS/WORKSHOPS/CONFERENCES ATTENDED
(Maximum of Ten)
Organizer
Duration
PART C:
EMPLOYMENT RECORD
(Last/Present Employer, First Given)
Employer
Position Held
Duration
Last Salary
(P.m.)
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PART D:
OTHER DETAILS
Give reasons for applying for this job: ..............................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
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Expected Salary:
Maximum: Kshs. ......................................... P.m.
Minimum : Kshs. ........................................ P.m.
Give datails of Two Referees:
1. ...........................................................................................
...........................................................................................
...........................................................................................
...........................................................................................
...........................................................................................
2. ...........................................................................................
...........................................................................................
...........................................................................................
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Candidate’s Signature: .................................................................
Date: .....................................
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Tom Mboya Avenue P.O. Box 90420-80100 Mombasa, Kenya
Tel: (254)41-2492222/3/4,2490571Fax: (254) 41-2495632, Mobile (254) 0724 955377/0733 955377
Website: www. [email protected]