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EMPLOYMENT APPLICATION FOR LOCALLY EMPLOYED STAFF OR FAMILY MEMBER

INSTRUCTIONS

SECTION 1: PERSONAL INFORMATION TO BE COMPLETED BY ALL APPLICANTS

Name - Last Name, First Name

Other names used – All other names used, including nicknames

Address – Current mailing address, including apartment number, building number, or mailing code

Email – Complete email address. (IMPORTANT: Most correspondence will be via email.)

Phone Number – Cellphone, mobile or landline

Does your relative work in this Embassy or Consulate?

Relative is a husband, wife, domestic partner, member of household, father, father-in-law, stepfather, mother, mother-in-law,

stepmother, son, son-in-law, stepson, daughter, daughter-in-law, stepdaughter, brother, brother-in-law, half-brother, sister, sister-

in-law, half-sister, uncle, aunt, first cousin, nephew, or niece.

SECTION 2: EDUCATION

Enter all that apply. You may be asked to provide a copy of your diploma or certification at the interview phase, or if asked by HR.

SECTION 3: LANGUAGES

The Mission assesses the language proficiency using the following standards:

1 Basic – Examples: I can use basic greetings and phrases; I can read numbers and signs.

2 Limited – Examples: I can give basic directions, simple questions.

3 Good Working Knowledge – Examples: Conversations about familiar topics, complex documents.

4 Fluent – Examples: Infer nuanced meaning from complex documents.

5 Translator – Examples: Certified professional translator in this language.

List language proficiency and identify the level for Speaking, Reading and Writing for each. The Vacancy Announcement states

whether these languages will or may be tested.

Language

Speaking (Provide level)

Reading (Provide level)

Writing (Provide level)

English

4 Fluent

Italian

2 Limited

1 Basic

SECTION 4: WORK EXPERIENCE

Paid and voluntary – Start with current experience and go back 10 years or longer, if relevant to this job.

Please complete all required information to the best of your knowledge. You must provide the month and year of your employment.

If you need additional space, please attach additional pages to your application.

Job Title

From (mm-yyyy)

To (mm-yyyy)

Yearly salary (Local Currency)

Secretary

Full Time

Part time

03-2001

03-2010

$20,000

Employer Name, Address and Phone Number

Dick Smith Law Firm, 26 Main Street, Cairns QDL 4870, 07-555-5555

Supervisory Responsibilities?

Supervisor Name

Yes

Peter Smith

Main Duties and Responsibilities

I typed legal documents and answered the telephone for two lawyers. I collected and distributed the mail. I made appointments for the two lawyers and welcomed

guests to the office.

Reason for leaving

I went to University of Queensland.

SECTION 5: CITIZENSHIP

Select all that apply and include the required documents (as stated) with the application. Additional documents may be requested

by HR at the interview phase.

SECTION 6: DECLARATION

All applicants must read the declaration and mark this agreement to proceed with the application.

DS-174

Page 1 of 1

05-2017

Form Ds-174 - Application For Employment As A Locally Employed Staff Or Family Member Page 4

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