Kosova Resource Data Sheet

DATE _________________________________

PLEASE COMPLETE ALL SECTIONS AND FOLLOW INSTRUCTIONS AT BOTTOM OF FORM Name _____________________________________________________________________ Last First Middle Maiden Present address _____________________________________________________________ Number Street City State Zip Profession: ___________ Telephone: ______________ Email Address________________ Kosovo ID Number__________________ Passport Number___________________ Passport Expiration Date_____________ Driver License _____________________ N/A N/A Driver License Expiration Date_________

Countries of Interest (1)_____________________ (2)_____________________ (3)_____________________

With my signature I authorize Kosova Resource to forward my information to any prospective employer. I also authorize Kosova Resource to conduct any inquiries they deem necessary to validate the information submitted on this data sheet or on the Kosova Resource employment application form. I acknowledge that Kosova Resource has made no promise of employment either implicitly or explicitly.

Signature___________________________________________ Date____________________ Instruction Note: This form should be completed, printed, signed and scanned into a PDF file. The file should be named in the following format: DatasheetLastName.FirstName.PDF. This file, along with the Kosova Resource employment application form should be emailed to recruiting@kosovaresource.com.