Allied Health

CANDIDATE PERSONAL DATA

Full Name (as per passport)
Phone Number (please make sure to include
your country code and area code)

Mobile:

00 (_ _ _) - _ _ _ _ _ _ _ _ _ _ _ _ _

Land-line: 00 (_ _ _) - _ _ _ _ _ _ _ _ _ _ _ _ _

Email Address

Skype ID

Mailing Address

Passport Issued

Date of Birth (dd/mm/year)

Place of Birth

Nationality

Number of Dependents

Marital Status
QUALIFICATIONS relevant to the job applied
Years of experience in role
applied for

Total years of experience

FORMAL EDUCATION
1.

Name of School or University

Location of School or University

Graduation Date & degree

received

Duration of Study

Major/Course Title

Study Method (circle those that apply)

2.

Distance

Classroom

Name of additional University

Location of University

Graduation Date & degree

received

Duration of Study

Major/Course Title

Study Method (circle those that apply)

3.

Online

Distance

Classroom

Online

Name of additional University

Location of University

Graduation Date & degree

received

Duration of Study

Major/Course Title

Study Method (circle those that apply)

Distance

Classroom

Online

HIGH SCHOOL
Name of High School
Location of High School
Graduation Date

Is the High School still in

existence and do you have a
transcript, or another source of
verification?

Yes

No

CERTIFICATIONS
1.

Name of Certification

2.

Name of Certification

Organization
awarding
Certification
Organization
awarding
Certification

Dates Certification is valid:

Dates Certification is valid:

LICENSE (IF APPLICABLE)

License

Number
Issue Date
Expiry Date
Issued By
Has your professional license been suspended
or revoked?
Does the license have any restrictions? If yes,
please specify
EMPLOYMENT HISTORY relevant to the job applied
1.

CURRENT Employment:

Employer Name

Employer
Location

Employment Period, start to termination

(dd/mm/year)

Job Title

Remarks add any additional job

responsibilities. Please be as detailed as
you can. Don say just Technician,
Specialist, etc.
Reason for Leaving
2.

Employment:

Employer Name

Employer
Location

Employment Period, start to termination

(dd/mm/year)

Job Title

Remarks add any additional job

responsibilities. Please be as detailed as
you can. Don say just Technician,
Specialist, etc.
Reason for Leaving
3.

Employment:

Employer Name

Employer
Location

Employment Period, start to termination

(dd/mm/year)

Job Title

Remarks add any additional job

responsibilities. Please be as detailed as
you can. Don say just Technician,
Specialist, etc.
Reason for Leaving

Completed skills checklist for specialty area is applicable, and is attached to this CV

If applying for managerial role:

Position title

Number of direct staff

supervised:

Language Skills (Circle all that apply) :

Name of Language

Speak

Read

Write

Understand

Arabic

Excellent / Good / Fair

Excellent / Good / Fair

Excellent / Good / Fair

Excellent / Good / Fair

English

Excellent / Good / Fair

Excellent / Good / Fair

Excellent / Good / Fair

Excellent / Good / Fair

Others (Specify):

Excellent / Good / Fair

Excellent / Good / Fair

Excellent / Good / Fair

Excellent / Good / Fair

Excellent / Good / Fair

Excellent / Good / Fair

Excellent / Good / Fair

Excellent / Good / Fair

Lapses in Employment:
Explain in lapses in employment, duration and reason.
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
Professional Organizations:
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
Prometric Exam
Taken

Yes/No

Score / Pass / Fail

I certify that the above information is true and correct to the best of my knowledge and ability.
Name: _________________________________
Signature: ______________________________
Date: __________________________________