2015-10-16
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Full names Mr/Mrs/Miss
Address
Married/Never married/ Widowed/Divorced/Separated___________
Date of birth_____________________________________________
Nationality_______________Country of birth__________________
Do you or any of your dependendants suffer, or have any of you ever suffered from any physical or mental disability? (Yes or No)_______
If yes, give full details_____________________________________ _______________________________________________________
Number and ages of children over the age of 1,5 years:
| Name | Age | Qualification | ||||
Have you ever resided in the USA, if so,
please give details
Items (A) and (D) must be completed by all applicants
Items (B) and (C) must only be completed if applicable
(A) School education: total number of years From To
Primary school ___________________________________________
Secondary/High school ____________________________________
Professional school _______________________________________
Highest examinations passed ________________________________
Major subjects ___________________________________________
(B) Higher education or special training:
Name of college, university or institution attended _______________ _______________________________________________________
Prescribed duration of course _______________________________
Period attended: From________________to____________________
Major subjects ___________________________________________
What degree, diploma or certificate obtained____________________
(C) Trade qualifications:
Duration of apprenticeship training; from__________to___________
Trade in which qualified____________________________________
(D) Record of employment: (these details must be in date
order including periods of unemployment for the last 20
years)
| Name of firm | City/Town in which located | From To | Nature of work |
(E) Describe briefly your present/last duties ____________________ _______________________________________________________
(F) What is the trade or business of your present/last
employer? _______________________________________________
(G) What is your present/ last monthly salary or income?__________
(H) What occupation do you intend following in USA? ___________
(I) Do you receive a pensio or do you have a private
income? If so, please give details ____________________________
(J) Have you an offer of employment in USA? If so, attach copy of the offer ________________________________________________
(K) Language proficiency: __________________________________
(a) What is your mother tongue? _____________________________
(b) What is your proficiency in other languages? (Answer YES or NO under the different headings)
| Language | Speak | Read | Write |
| English | |||
(L) Details regarding relatives and friends in the USA
| Name | Address | Relationship |
Date _____________________________________________________
ІІІ. Письмово перекладіть всі пункти анкети українською мовою.
Питання для самоконтролю:
1. Are there different types of questionnaires in every country?
2. When are questionnaires used?
3. To fill in a questionnaire is just a formality, isn`t it?
4. Can a questionary influence one`s professional career?
Рекомендована література:
1. Business Writing Clear and Simple Copyright © 2007 Learning Express, LLC.
2.David Chappell, Derek Marshall Vinsent, Power-Smith Simon Cavender. Building Contract Dictionary.Third Edition.
3.John Forster.Effectiv writing skills for Public Relations. Forth Edition.
Дидактичне забезпечення: анкета, українсько-англійський словник.
