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Fields marked with an asterik (*) are required. 2QO\IXOO\FRPSOHWHGDSSOLFDWLRQIRUPVZLOOEHFRQVLGHUHG. Please DO NOT submit
scans of certificates with your application form.

---No application will be considered unless accompanied by a CV and cover letter.---

---No CVs and cover letters will be considered unless accompanied by a fully completed application form.---

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First Name* Middle Name* Last Name*

Phone # (main)* Phone # (alternative) E-mail Address*

How did you hear about this position? (select from drop down menu; enter details if 'Other')*

Have you previously applied to/worked at ATA?*

Yes-worked at ATA Yes-applied to ATA No

If yes, please list most recent position previously held/applied for at ATA:

Start Date (mm/yyyy) End Date (mm/yyyy)

Language Skills (Please list your languages and indicate your level of proficiency for Speaking, Reading and Writing in each
language from the drop down menu)*

Language Speak Read Write

Language Speak Read Write

Language Speak Read Write

Language Speak Read Write

Are you currently in Addis Ababa and available for in-person interviews at ATA?*

Yes No

If offered this position, how soon would you be able to start? (select from drop down; enter details if 'Other')*

Would you be interested in a position working for a duration of less than 6 months?*

Yes No

If you are applying for a position that includes driving a vehicle, do you have a valid driver's license?

Yes No

Do any of your relatives or members of your household work for the ATA? If yes, please provide details below*

Yes No

Name Relationship Position & Location

Name Relationship Position & Location

Professional Experience (list most recent position first; up to four relevant positions to be listed below)

Total Years & Months

professional experience

Total number of positions held* Years* Months*

1. Position Title (most recent)* Organization Name (most recent)*

Total Years/Months
at this Position:

Start Date (mm/yyyy)* End Date (mm/yyyy)* Years* Months

Main Responsibilities (List up to three responsibilities)*

Main Achievements (List up to three achievements)*

Current/Most Recent Monthly Salar*y Please specify Currency paid in (i.e.Birr, USD, Euro)*

If no longer at this position, reason for leaving*:

2. Position Title Organization Name

Total Years/Months
at this Position:

Start Date (mm/yyyy) End Date (mm/yyyy) Years Months

Main Responsibilities (List up to three responsibilities; maximum 800 characters)*

Main Achievements (List up to three achievements; maximum 800 characters)*

Reason for Leaving

3. Position Title Organization Name

Total Years/Months
at this Position

Start Date (mm/yyyy) End Date (mm/yyyy) Years Months

Main Responsibilities (List up to three responsibilities; maximum 800 characters)

Main Achievements (List up to three achievements; maximum 800 characters)

Reason for Leaving

4. Position Title Organization Name

Total Years/Months
at this Position

Start Date (mm/yyyy) End Date (mm/yyyy) Years* Months

Main Responsibilities (List up to three responsibilities; maximum 800 characters)

Main Achievements (List up to three achievements; maximum 800 characters)

Reason for Leaving

Academic Qualifications (List most recent degree first; up to three degrees to be listed below)

Most Recent Degree (select from drop down menu)* Subject (select from drop down menu)*

Start Date End Date

Educational Institution (select from drop down menu)* (mm/yyyy)* (mm/yyyy)*

Degree (select from drop down menu) Subject (select from drop down menu)

Start Date End Date

Educational Institution (select from drop down menu) (mm/yyyy) (mm/yyyy)
Degree (select from drop down menu) Subject (select from drop down menu)

Start Date End Date

Educational Institution (select from drop down menu) (mm/yyyy) (mm/yyyy)

Professional Associations, Licenses, etc.

List professional organizations, associations you are a member of that you consider relevant to the position (if none,
please insert "none): "*

List any award/honors, fellowships and/or publications you consider relevant to the position (if none, please insert
"none): "*

List professional licenses, certifications, computer skills, training and other skills and abilities you consider relevant to the
position (if none, please insert "none):*

References (Please provide three professional references, one of whom has held a position of authority above you)

1. First Name* Last Name*

Position* Organization Name*

E-mail Address* Phone*

How many years has this person known you?* What is his/her relationship to you?*

2. First Name* Last Name*

Position Title (most recent)* Organization Name*

E-mail Address* Phone*

How many years has this person known you?* What is his/her relationship to you?*

3. First Name* Last Name*

Position* Organization Name*

E-mail Address* Phone*

How many years has this person known you?* What is his/her relationship to you?*

By submitting this application form, I certify that all the information I have given is complete, true, correct
and made in good faith. I understand that any false or fraudulent statement or information on this
application or attached to/provided in connection with this application may be grounds for not being hired
or termination/dismissal and may be punishable by fine or imprisonment according to Ethiopian law.

***Please SAVE this application form & send it along with your CV (maximum 5 pages) and Cover Letter
to Recruitment@ata.gov.et***

9/2014