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

Name of School, City, State

Yes

Or Country

From

- -

Other, e.g. Technical/Vocational

Dates Attended

Graduate?

Degree/Diploma

School

(mm-dd-yyyy)

Name of School, City, State

Yes

Or Country

From

- -

LICENSES, SKILLS, TRAINING, MEMBERSHIP, AND RECOGNITION

22. List professional licenses, certifications, typing/keyboard, computer skills, formal and on-line training, and other skills

and abilities you consider relevant to the position. Please include the license or certification number. Attach a copy if the

licensing or certification is a requirement of the position. If licensed in the U.S., please list the state of issuance. If licensed

in another country, please list the province/state/region and country of issuance. (Use additional pages, as required)

23. List professional organizations, associations, awards, honors, fellowships, and publications you consider significant.

LANGUAGES

24. List your languages, the appropriate competency levels, and your primary/first spoken/native language using the

language standards below. You may only identify one primary/first spoken/native language.

Language Indicators

DS-174

Page ! 4

12-2009

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