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CARE International Nepal | Samata Bhawan | Dhobighat | Lalitpur
Phone: 01-5522800 | Fax: 01-5521202
Application via email: apply@np.care.org | web: www.carenepal.org
2014
CARE Nepal Application Form for Employment
1. Application for the Position of:
First Name Family Name Middle Name
Gender Marital Status
Male Female Married Not married Single
Date of Birth / Place of Birth
Day Month Year Place of
Birth
Nationality at Birth Present Nationality
Email Address Telephone contact No
Residence:
Office:
Mobile:
Permanent Address Current Residence Address (If different from
Permanent)
2. Have you any dependents? If Yes, give the following information:
Name Date of birth Relationship Name Date of birth Relationship
Page 1
CARE International Nepal | Samata Bhawan | Dhobighat | Lalitpur
Phone: 01-5522800 | Fax: 01-5521202
Application via email: apply@np.care.org | web: www.carenepal.org
2014
CARE Nepal Application Form for Employment
3. Are any of your relatives employed in CARE International? If your answer is Yes, please provide following
information
Name Relationship Location within CARE
International
Date and Year
4. Languages - List
mother tongue first
(Tick in the
appropriate cell)
Ability to read Ability to write Ability to speak
Excellent Good Basic Excellent Good Basic Excellent Good Basic
5. Academic Qualification
Give full details - Please give exact titles of degrees in original language
University or equivalent (most recent first) of the educational institutions you have attended and other
Page 2
CARE International Nepal | Samata Bhawan | Dhobighat | Lalitpur
Phone: 01-5522800 | Fax: 01-5521202
Application via email: apply@np.care.org | web: www.carenepal.org
2014
CARE Nepal Application Form for Employment
specialized courses. (Please do not translate or equate to other degrees.)
Qualification
Name of
School/College /
Institution/ University
Address Exact
Title of
degree
Earned
Board
University
Main Course
of Study/Area
of
specialization
Year
completed
6. Professional Experience
Starting with your present post, list in reverse order every employment you have had.
Use separate block for each employment.
6.1. Present Posts
Exact Title of Your Current Post Name and Address of Employer Name of Current Supervisor
and his/her Post
From
Month / Year
To
Month / Year
Brief Description of Duties Any other position held in the
current organization
6.2. Previous Posts : (In Reverse Order- i.e. Most Recent Posts First)
Page 3
CARE International Nepal | Samata Bhawan | Dhobighat | Lalitpur
Phone: 01-5522800 | Fax: 01-5521202
Application via email: apply@np.care.org | web: www.carenepal.org
2014
CARE Nepal Application Form for Employment
Exact Title of Your Post Name and Address of Employer Name of Supervisor and
his/her Post
From
Month / Year
To
Month / Year
Brief Description of your Current Duties Any other position held in the
current organization
6.3. Previous Posts :
Exact Title of Your Post Name and Address of Employer Name of Supervisor and
his/her Post
From
Month / Year
To
Month / Year
Brief Description of Duties Any other position held in the
organization
6.4. Previous Posts :
Exact Title of Your Post Name and Address of Employer Name of Supervisor and
his/her Post
From
Month / Year
To
Month / Year
Brief Description of Duties Any other position held in the
organization
6.5. Previous Posts :
Exact Title of Your Post Name and Address of Employer Name of Supervisor and
Page 4
CARE International Nepal | Samata Bhawan | Dhobighat | Lalitpur
Phone: 01-5522800 | Fax: 01-5521202
Application via email: apply@np.care.org | web: www.carenepal.org
2014
CARE Nepal Application Form for Employment
his/her Post
From
Month / Year
To
Month / Year
Brief Description of Duties Any other position held in the
organization
6.6. Previous Posts :
Exact Title of Your Post Name and Address of Employer Name of Supervisor and
his/her Post
From
Month / Year
To
Month / Year
Brief Description of Duties Any other position held in the
organization
Three Recent and Relevant Publication (Please do not attach the publication)
Award Received (if any)
7. Relevant Training Attended
Page 5
CARE International Nepal | Samata Bhawan | Dhobighat | Lalitpur
Phone: 01-5522800 | Fax: 01-5521202
Application via email: apply@np.care.org | web: www.carenepal.org
2014
CARE Nepal Application Form for Employment
SNo. Name of the Training Attended
Course Title
Conducted by
(Agency /
Individual)
Location Duration and
year
7.1. List other significant training that does have direct relevance to positions applied.
SNo. Name of the Training Attended Conducted by
(Agency /
Individual)
Place Duration
8. Summarize special job-related skills relevant to this particular position or state why you are fit for this
position?
(You may enter up to 1500 characters )
9. Why do you want to join CARE Nepal?
Page 6
CARE International Nepal | Samata Bhawan | Dhobighat | Lalitpur
Phone: 01-5522800 | Fax: 01-5521202
Application via email: apply@np.care.org | web: www.carenepal.org
2014
CARE Nepal Application Form for Employment
(You may enter up to 1500 characters)
10. Name of Reference
List three persons, not related to you, who are familiar with your character, qualification and competence and
can be reached for your reference check. Including at least one from a previous supervisor.
Reference 1.
Name
Phone
Mobile
Email
Position
Organization
Nature of Professional relation
Reference 2.
Name
Phone
Mobile
Email
Position
Organization
Nature of Professional relation
Page 7
CARE International Nepal | Samata Bhawan | Dhobighat | Lalitpur
Phone: 01-5522800 | Fax: 01-5521202
Application via email: apply@np.care.org | web: www.carenepal.org
2014
CARE Nepal Application Form for Employment
Reference 3.
Name
Phone
Mobile
Email
Position
Organization
Nature of Professional relation
11. Have you ever been arrested, indicted, or summoned into court as a defendant in a criminal proceeding or
convicted, fined or imprisoned for the violation of any law (excluding minor traffic violations)?
Yes No
If Yes, mention briefly your case
I certify that the statements made by me in answer to the foregoing question are true, complete and correct
to the best of my knowledge and belief. I understand that any misrepresentation or material omission made in
CARE Nepal Application Form or other document requested by the organization render me liable to
disqualification, termination or dismissal.
Date: Name:
Signature
Page 8

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  • 3. CARE International Nepal | Samata Bhawan | Dhobighat | Lalitpur Phone: 01-5522800 | Fax: 01-5521202 Application via email: apply@np.care.org | web: www.carenepal.org 2014 CARE Nepal Application Form for Employment specialized courses. (Please do not translate or equate to other degrees.) Qualification Name of School/College / Institution/ University Address Exact Title of degree Earned Board University Main Course of Study/Area of specialization Year completed 6. Professional Experience Starting with your present post, list in reverse order every employment you have had. Use separate block for each employment. 6.1. Present Posts Exact Title of Your Current Post Name and Address of Employer Name of Current Supervisor and his/her Post From Month / Year To Month / Year Brief Description of Duties Any other position held in the current organization 6.2. Previous Posts : (In Reverse Order- i.e. Most Recent Posts First) Page 3
  • 4. CARE International Nepal | Samata Bhawan | Dhobighat | Lalitpur Phone: 01-5522800 | Fax: 01-5521202 Application via email: apply@np.care.org | web: www.carenepal.org 2014 CARE Nepal Application Form for Employment Exact Title of Your Post Name and Address of Employer Name of Supervisor and his/her Post From Month / Year To Month / Year Brief Description of your Current Duties Any other position held in the current organization 6.3. Previous Posts : Exact Title of Your Post Name and Address of Employer Name of Supervisor and his/her Post From Month / Year To Month / Year Brief Description of Duties Any other position held in the organization 6.4. Previous Posts : Exact Title of Your Post Name and Address of Employer Name of Supervisor and his/her Post From Month / Year To Month / Year Brief Description of Duties Any other position held in the organization 6.5. Previous Posts : Exact Title of Your Post Name and Address of Employer Name of Supervisor and Page 4
  • 5. CARE International Nepal | Samata Bhawan | Dhobighat | Lalitpur Phone: 01-5522800 | Fax: 01-5521202 Application via email: apply@np.care.org | web: www.carenepal.org 2014 CARE Nepal Application Form for Employment his/her Post From Month / Year To Month / Year Brief Description of Duties Any other position held in the organization 6.6. Previous Posts : Exact Title of Your Post Name and Address of Employer Name of Supervisor and his/her Post From Month / Year To Month / Year Brief Description of Duties Any other position held in the organization Three Recent and Relevant Publication (Please do not attach the publication) Award Received (if any) 7. Relevant Training Attended Page 5
  • 6. CARE International Nepal | Samata Bhawan | Dhobighat | Lalitpur Phone: 01-5522800 | Fax: 01-5521202 Application via email: apply@np.care.org | web: www.carenepal.org 2014 CARE Nepal Application Form for Employment SNo. Name of the Training Attended Course Title Conducted by (Agency / Individual) Location Duration and year 7.1. List other significant training that does have direct relevance to positions applied. SNo. Name of the Training Attended Conducted by (Agency / Individual) Place Duration 8. Summarize special job-related skills relevant to this particular position or state why you are fit for this position? (You may enter up to 1500 characters ) 9. Why do you want to join CARE Nepal? Page 6
  • 7. CARE International Nepal | Samata Bhawan | Dhobighat | Lalitpur Phone: 01-5522800 | Fax: 01-5521202 Application via email: apply@np.care.org | web: www.carenepal.org 2014 CARE Nepal Application Form for Employment (You may enter up to 1500 characters) 10. Name of Reference List three persons, not related to you, who are familiar with your character, qualification and competence and can be reached for your reference check. Including at least one from a previous supervisor. Reference 1. Name Phone Mobile Email Position Organization Nature of Professional relation Reference 2. Name Phone Mobile Email Position Organization Nature of Professional relation Page 7
  • 8. CARE International Nepal | Samata Bhawan | Dhobighat | Lalitpur Phone: 01-5522800 | Fax: 01-5521202 Application via email: apply@np.care.org | web: www.carenepal.org 2014 CARE Nepal Application Form for Employment Reference 3. Name Phone Mobile Email Position Organization Nature of Professional relation 11. Have you ever been arrested, indicted, or summoned into court as a defendant in a criminal proceeding or convicted, fined or imprisoned for the violation of any law (excluding minor traffic violations)? Yes No If Yes, mention briefly your case I certify that the statements made by me in answer to the foregoing question are true, complete and correct to the best of my knowledge and belief. I understand that any misrepresentation or material omission made in CARE Nepal Application Form or other document requested by the organization render me liable to disqualification, termination or dismissal. Date: Name: Signature Page 8