1

Proposed Position:

Name of Firm:

Name of Expert:

Date of Birth:

Complete personal contact details:

Name:

Citizenship:

Address:
Phone:
Email:

6.

Education:

7.

Membership in Professional Associations:

8.

Other Training:

9.

Countries of Work Experience:

10.

Languages:
Level of Proficiency (Mother tongue, Excellent, good, fair, poor)

11.

Language
Bahasa

Speaking
Mother

Reading
Mother

Writing
Mother tongue

Indonesia English

tongue

tongue

Excellent

Employment Record

Excellent

Excellent

From:

To: Present

Name of Employer:

Detailed Tasks Assigned:

Work Undertaken that Best Illustrates Capability to Handle The Tasks Assigned:

From:

To:

Name of Employer:
Detailed Tasks
Assigned:
Work Undertaken that Best Illustrates Capability to Handle The Tasks Assigned:

From:
To:
Name of Employer:
Detailed Tasks
Assigned:
Work Undertaken that Best Illustrates Capability to Handle The Tasks Assigned:

From:
To:
Name of Employer:
Detailed Tasks
Assigned:
Work Undertaken that Best Illustrates Capability to Handle The Tasks Assigned:

4.

Certification:
I certify that I have been informed by the firm that it is including my CV in the proposal for the [name
of the project]. I confirm that that I will be available to carry out the assignment for which my CV has
been submitted, in accordance with the implementation arrangements and schedule set out in the
proposal.
I understand that any willful misstatement may lead to disqualification or dismissal, and any other
ADB disciplinary action.
Date:

Signature and Complete Name

Day/Month/Year