Allied Health

CANDIDATE PERSONAL DATA

Full Name (as per passport)
Phone Number (please make sure
to include your country code and
area code)

Mobile:

00 (_ _ _) - _ _ _ _ _ _ _ _ _ _ _ _ _

Land-line: 00 (_ _ _) - _ _ _ _ _ _ _ _ _ _ _ _ _

Email Address

Skype ID

Mailing Address

Passport Issued

Date of Birth (dd/mm/year)

Place of Birth

Nationality

Number of Dependents

Marital Status
QUALIFICATIONS relevant to the job applied
Years of experience in
role applied for

Total years of experience

FORMAL EDUCATION
1. Name of School or University
Location of School or University

Graduation Date &

degree received

Duration of Study

Major/Course Title

Study Method (circle those that

apply)

Distance

Classroom

Online

2. Name of additional University

Location of University

Graduation Date &

degree received

Duration of Study

Major/Course Title

Study Method (circle those that

apply)

Distance

Classroom

Online

3. Name of additional University

Location of University

Graduation Date &

degree received

Duration of Study

Major/Course Title

Study Method (circle those that

apply)

Distance

Classroom

Online

HIGH SCHOOL
Name of High School
Location of High School
Graduation Date

Is the High School still

in existence and do you
have a transcript, or
another source of
verification?

Yes

No

CERTIFICATIONS
Organizatio
n awarding
Certificatio
n
Organizatio
n awarding
Certificatio
n

1. Name of Certification

2. Name of Certification

Dates Certification is
valid:

Dates Certification is
valid:

LICENSE (IF APPLICABLE)

License

Number
Issue Date
Expiry Date
Issued By
Has your professional license
been suspended or revoked?
Does the license have any
restrictions? If yes, please
specify
EMPLOYMENT HISTORY relevant to the job applied
1. CURRENT Employment:
Employer Name

Employer
Location

Employment Period, start to

termination (dd/mm/year)

Job Title

Remarks add any additional

job responsibilities. Please be
as detailed as you can. Don
say just Technician,
Specialist, etc.
Reason for Leaving
2.

Employment:

Employer Name

Employer
Location

Employment Period, start to

termination (dd/mm/year)

Job Title

Remarks add any additional

job responsibilities. Please be
as detailed as you can. Don
say just Technician,
Specialist, etc.
Reason for Leaving
3. Employment:
Employer Name

Employer
Location

Employment Period, start to

termination (dd/mm/year)

Job Title

Remarks add any additional

job responsibilities. Please be

as detailed as you can. Don

say just Technician,
Specialist, etc.
Reason for Leaving

Completedskills checklist for specialty area is applicable, and is attached to this CV

If applying for managerial role:

Position title

Number of direct
staff supervised:

Language Skills (Circle all that apply) :

Name of Language

Speak

Read

Write

Understand

Arabic

Excellent / Good /
Fair

Excellent / Good /
Fair

Excellent / Good /
Fair

Excellent / Good /
Fair

English

Excellent / Good /
Fair

Excellent / Good /
Fair

Excellent / Good /
Fair

Excellent / Good /
Fair

Others (Specify):

Excellent / Good /
Fair

Excellent / Good /
Fair

Excellent / Good /
Fair

Excellent / Good /
Fair

Excellent / Good /
Fair

Excellent / Good /
Fair

Excellent / Good /
Fair

Excellent / Good /
Fair

Lapses in Employment:
Explain in lapses in employment, duration and reason.
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
Professional Organizations:
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
Prometric Exam
Taken

Yes/No

Score

Pass

/ Fail

I certify that the above information is true and correct to the best of my knowledge and ability.
Name: _________________________________
Signature: ______________________________
Date: __________________________________