ࡱ> TVS5@ [bjbj22(fXX>>>>>>>R: : : : d R $?R-> >> C > >  &>> @/: Y0I"IRR>>>>I>  RRd  RR =:5B0 70?>;=O5BAO B>;L:> @CG:>9 A G5@=>9 ?0AB>9 8 ?5G0B=K<8 1C:209 AB@>:5 CG0AB=8: 4>;65= =0?8A0BL 53> $0<8;8N 8 @B5). >60;C9AB0, ?@>A;548B5 GB>1K D0A;5 A;>2 Last name 8 8A;5 A;>2 First name, 0 =5 =0>1>@>B. Middle initial - ?5@2K5 425 1C:2K >BG5AB20 CG0AB=8:0.2 Present Street Address (0AB>OI89 04@5A)0AB>OI89 04@5A - MB> 04@5A, 345 CG0AB=8: ?@>68205B =0 40==K9 <5=B.8H5<5@ :20@B8@K (=0?@83> 4> :0: Chernyshevskogo 15-521).>B>< ?8H5@>4, 70B5GB>2K9 8=45:A 8 40;55 =0720=85 AB@0=K. Valid until  >7=0G05B 4> :0:>3> 2@56820BL ?> MB><C 04@5AC. 8H5, 70B5< <5AOF 1C:20<8 (6=> F8D@04 F8D@0 2K3;O48B B0: 15 July, 2003 8;8 15/07/2003. A;8 CG0AB=8: 6825B ?> MB>AB>O==>, B> B>340 =C6=> ?8A0BL Permanent.Telephone number  CG0AB=8: ?8H5B A2>9 B5;5D>==K9 =>40 AB@0=K (4;O >AA88 MB> 7, 4;O 0B288  371, AB>=88  372, 8B2K  370, 5;>@CAA88  375, #:@08=K  380 8 B0: 40;55), 70B54 3>@>40 8 =>=0. 3 A;8 ?>AB>O==K9 04@5A CG0AB=8:0 (Permanent address) >B;8G05BAO >B =0AB>OI53> 04@5A0 (Present address), B> B>340 CG0A=8: 4>;65= 70?>;=8BL A2>9 ?>AB>O==K9 04@5A 2 A;54CNI8E AB@>:0E:Permanent Street Address, City, Postal Code, Country.Valid Until - 2 MB>9 AB@>:5 CG0AB=8: 4>;65= ?>AB028BL Permanent.A;8 ?>AB>O==K9 04@5A 8 =0AB>OI89 04@5A A>2?040NB, B>340 CG0AB=8: ;81> ?5@5?8AK205B A2>9 04@5A 5I5 @07, ;81> ?@>?CA:05B AB@>:8 :0A0NI85AO ?>AB>O==>3> 04@5A0. 4 City of birth  =0720=85 3>@>40, 2 :>B>@>48;AO CG0AB=8:. A;8 2 703@0=8G=>@B5 CG0AB=8:0 =5 =0?8A0=> =0720=85 3>@>40 (>1KG=> 5A;8 MB>B 3>@>4 = (>=0) @>48;8AL, 0 2 MB>3> =0?8A0=> =0720=85 >1;0AB8, B> CG0AB=8: B0:65 ?8H5B =0720=85 >1;0AB8 2 AB@>:5 City of birth. 5 Country of birth  =0720=85 AB@0=K 2 :>B>@>9 @>48;AO CG0AB=8:.6 E-mail address  M;5:B@>==K9 04@5A, 5A;8 B0:>2>9 C CG0AB=8:0 8B>@>9 CG0AB=8: 6825B ;530;L=> 2 40==K9 <5=B 2@5B>@0O 2K40;0 CG0AB=8:C ?0A?>@B.9 Country of citizenship  =0720=85 AB@0=K, ?>40=AB2> :>B>@9 8;65= >B>B25BAB2CNI89 5645=8O CG0AB=8:0. =0 4>;6=0 1KBL =0?8A0=0 2  5ABL A=0G0;0 ?8H5BAO  1C:20<8), 70B5=F5 ?>;=>ABLN 3>4. 12 Work experience  CG0AB=8: 70?>;=O5B 2 A>>B25BAB288 A 53> (55) >?KB>BK. Type of work/title  CG0AB=8: C:07K205B 4>;6=>ABL, :>B>@CN >= (>=0) 70=8<0;8, =0?@8BK :>B>@K5 >= (>=0) 2K?>;=O;8, =0?@8<?0=88, D8@B>@>B0;.Dates  40BK, :>340 CG0AB=8: @01>B0; 2 MB>9 :><?0=88, D8@AB8=8FK, @5AB>@0=0...), 345 CG0AB=8: A>18@05BAO @01>B0BL.Contact person  8<O 8 D0<8;8O <5=5465@0 A :53>20@820;AO ?> ?>2>4C @01>BK. Telephone Number  B5;5D>==K9 =>3> 340 >= =0G0; 8A:0BL @01>BC.15 What companies have you applied to?   :0:8B040B5;O1@0I0;AO 5I5, ?><8 B>3> @01>B>40B5;O C :>B>@>3> CG0AB=8: A>18@05BAO @01>B0BL (=C6=> ?5@5G8A;8BL =5A:>;L:>, 5A;8 B0:>2K5 8B>40B5;59 (=5 2:;NG0O B>3>, : :>B>@>B0BL) >B :>B>@KE CG0AB=8: ?>;CG8; ?@83;0H5=85 =0 @01>BC.17 How have you researched finding a job or company (internet, friends, etc.)?  CG0AB=8: 4>;65= C:070BL A?>A>1K, A ?>ILN :>B>@KE >= 8A:0; @01>BC (8=B5@=5B, G5@57 4@C74F`*  " 0 8 D F h |  , Z x پphK3nhaYCJaJmHsHhK3nh+WCJaJhK3nhuqCJaJhK3nhuqCJaJmHsHhK3nh=CJaJhK3nh=CJaJmHsHhK3nh+WCJaJmHsHhT*CJaJmHsHh+WCJaJmHsHh]6CJaJmHsHh+Wh+WCJaJmHsH, f <:p^x$P4bgd+W [(f^dlnx "$6:LNZ0HZ\jlȽ񣔣vȽȽȽȽhK3nhU%CJaJmHsHhK3nhOHCJaJmHsHhK3nhC'^CJaJmHsHhK3nhC'^CJaJhK3nh=QCJaJmHsHhK3nh@`AACEFvILVP8SBUUdVVW>XgdiLgdr#dgdN Kgd_1gd+W !!!!!!!,"@"R"T"`""""",##P#R#Z#^#h#j#n#p#z#|#################,$l$2%6%8%@%B%H%J%Z%\%b%d%p%r%z%|%%%%%%&&&׽׽׽׽hK3nhzCJaJmHsHhK3nhzCJaJhK3nh_1CJaJmHsHhK3nh_1CJaJhK3nh'CJaJmHsHJ&&&&&&&&&&&&&&&&&' '' '.'2'8''>>> >(>*>4>6>:>D>F>L>N>T>V>d>f>l>>>>>>??? ??? ?"?(?@@@ @@@@@ @,@.@2@4@:@;6=> 1KBL =0?8A0=> :0:>9 B8? @01>BK CG0AB=8: 8I5B.19 What locations are you looking for?  CG0AB=8: ?8H5B 3@0D8G5A:>5 =0720=85: HB0B, 3>@>4 8;8 G0ABL = E>B5; @01>B0BL.20 Do you have family in the US, if so where?  A;8 CG0AB=8: 84AB25==8:>2 2 !(, B> >= C:07K205B 345 >=8 682CB (3>@>4 8 HB0B). A;8 C =53> =5B B0:8E, B> AB028BAO N/A.21 Have you been to the U.S.?  >B25B 4>;65= 1KBL  8;8 "22 Have you been on J-1 visa?  >B25B  8;8 ", 5A;8 >B25B , B> CG0AB=8: 4>;65= =0?8A0BL =0720=85 ?@>3@0<=A>@0 ?@>3@0<;5B0 2 !(. -B0 40B0 4>;6=0 1KBL =0?8A0=0 2 2@>?59A:> 5ABL A=0G0;0 ?8H5BAO 45=L, 70B5< =F5 3>4. >60;C9AB0, ?@>A;548B5 GB>1K MB> 40B0 =5 A>2?040;0 A 40B>9 2K;5B0 PLACED CG0AB=8:>2. 24 First day of work  40B0 =0G0;0 @01>BK CG0AB=8:0. 1KG=> 9 40B>9 8 40B>9 ?>;5B0 ACI5AB2C5B @07=8F0 2 420 4=O.25 Last day available to work  ?8H5BAO 40B0, :>340 CG0AB=8: E>G5B 70:>=G8BL @01>BC. @>: 2@5<5=8 9 ?@8;5B0 2 !( 8 >:>=G0=85BK 4>;65= 1KBL =5 <5=LH5 2.5 ;LH5 4 <5AOF52. @8:>=G0=85 @01>BK =5 >7=0G05B >:>=G0=85 459AB28O ?@>3@0<<K, B0: :0: CG0AB=8: 8A;5 B>3> :0: 70:>=G8B @01>B0BL.26 State of Health and Remarks  5A;8 CG0AB=8: 74>@>2 8 =5 81 =0 A2>5 74>@>2L5, B> =C6=> =0?8A0BL  I am in good health or  No problems with health . A;8 CG0AB=8: 8<5; 8;8 8 ?@>1;5 A2>8@>2L5 >= 4>;65= >?8A0BL 8E.  A?8A>: 1>;57=59 4>;6=K 1KBL 2:;NG5=K 0;;5@388, 485BK, @5;838>7=K5 >1O70==>AB8 >B=>A8B5;L=> ?8I8. #G0AB=8: 65B 8A?>;L7>20BL 4>?>;=8B5;L=K9 ;8AB 1C<038, 5A;8 5 =5>1E>48.27 Emergency Contact Address (must be English speaking)  70?>;=O5BAO <O 8 $0==K9 04@5A, #;8F0 (?>A;5 A;>2 Emergency contact s mailing address), >@>4, >GB>2K9 8=45:A 8 !B@0=0 G5;>25:0, A :>B>@K< 6=> A2O70BLAO 2 A;CG05, 5A;8 GB>-B> M:AB@0>@48=0@=>5 ?@>8AE>48B A CG0AB=8:> 2@5 =0E>645=8O 2 !(, =0?@8;8F859, ?>?040=85 CG0AB=8:0 2 3>A?8B0;L 2 A;CG05 ?A8E8G5A:>3> @0AAB@>9AB20 8 B0: 40;55.  AB@>:5 Emergency contact s phone number ?8H5BAO B5;5D>==K9 =>3> G5;>25:0 8 2 AB@>:5 Emergency contact person s relationship to you ?8H5BAO 53> >B=>H5=85 : CG0AB=8:C, B> 5ABL ;81> MB> @>48B5;8 (parents), ;81> 4@C3 (friend), ;81> CG8B5;L (teacher) 8 B0: 40;55. 4=0 ACI5AB25==0O 45B0;L, MB>B G5;>25: 4;O M:AB@5==>9 A2O78 4>;65= 3>2>@8BL 8 ?>=8-0=3;89A:8.28 Parent Information  CG0AB=8: ?8H5B 8BF0 8 :5= @01>B05B, 8<O <0B5@8 8 :5=0 @01>B05B, B5;5D>= @>48B5;59, M;5:B@>==K9 04@5A (5A;8 5ABL), 3>@>4 8 AB@0=C 345 682CB @>48B5;8. A;8 CG0AB=8: =5 848B5;59, B> B>340 2 848B5;9 AB028B N/A. 29 University presently attending  =0720=85 C=825@A8B5B0, 2 :>B>@>ABC?;5=8O 2 C=825@A8B5BEstimated date of graduation  ?@54?>;>68B5;L=0O 40B0 >:>=G0=8O C=825@A8B5B0Years of English total ___secondary school ___university ____ - A:>;L:> ;5B CG0AB=8: 87CG05B =3;89A:89 O7K:Other languages spoken  2;045=85 4@C38<8 O7K:01 CA;>28OE CG0AB8O 2 ?@>3@0<4?8AK205B  Personal declaration , B5< A0<K4B25@640O, GB> >= (>=0) A>3;0A=K A CA;>28O3@0<@B>@CN >=8 40;8 2 0=:5B5, O2;O5BAO ?>;=>9 8 ?@02482>9. A;8 CG0AB=8: 2 2>7@0AB5 4> 21 3>40, B> >48= 87 53> @>48B5;59 B0:65 4>;65= ?>4?8A0BL MBC 0=:5BC. `AdAfAnApAvAxAAAAAAAAAAAAAAAAAAAABBB BBBBBBBBBBBBBB$C(CBCFCNCPCVCZCbCdCrCvC~CCCCCCCCCCȽȽȽȽȽȽȽȽȽȽȽhK3nhr#dCJaJhK3nhr#dCJaJmHsHhK3nhN KCJaJhK3nhN KCJaJmHsHhK3nh_1CJaJhK3nh_1CJaJmHsHhK3nh:CJaJmHsH@CCCCCCCCCCEEEEEEEEEEEEEEPFjFFFFFFFFFFFFFvIxI|IIIIIIIIII^J`JbJfJhJlJnJvJxJJJJJJJJJJJJLLLLMMMM"M*M,M0M2M@MBMRMhK3nhCJaJmHsHhK3nhr#dCJaJmHsHhK3nhr#dCJaJURMMMMMMNNNN N*O|OhPzP|PPPPPPPPQ"Q$Q2Q4Q@QBQDQFQ^Q`QdQfQlQQQR RBRPR8S:S>SJSLSbS6U8U:UX@X [ [[[[[[[[[[ [gd+Wgd_1gdr#dgdiL&1h:p>=^/ =!"#$%B@B 1KG=K9CJ_HaJmH sH tH BAB A=>2=>9 H@8DB 0170F0XiX 1KG=0O B01;8F04 l4a .k. 5B A?8A:0fFG@AmF8nOP{u n ( y  S TQiNm%,y000000000000 00000 00000000 0 0 000000 000000000000p00@000@0 @0 @0 00p000p0p00p000 0 00mFn O9008y$bO900M900M900O9000O900O900G90 08y cG90 0G90 0O9008y d &`ACRM^U [./01b>X [2 [01EGab 45>\efkm|}-<=28 ] ^ a b l n q % ( + = E F y # + , 7 8 > ? F G I K N P Y [ c    & ' F G R S V f  3=>CDSS 4k+Wkqx"#/0MNPn(]p&'.?@OVWabghmnvwxy$ +KyQ_lm|~EG ?R\mEF7nNPz{u  m n ' ( x S PQhiMNlm$%~33333333EdwardOsvita<;|=Reu@'aYg, U%'5FN KiLCS=^r#dK3nPlnTprr[snvH{8V]6ULor_1kbYT*zSW;!=Q!D8 OHv+W Guq:0MJb$8t_UT@( PPP>UnknownG:Times New Roman5Symbol3& :Arial"qh:r&:r&63kf77#24d{{ 3QH)?G;=:5B0 70?>;=O5BAO B>;L:> G5@=>9 ?0AB>9 8 ?5G0B=K<8 1C:20<8EdwardOsvita Oh+'0 ( 8D ` l x< EdwarddwadwaNormalOsvita2viMicrosoft Word 10.0@F#@ς@c@c ՜.+,0( hp|  IEC7{A <    !"#$%&'()*+,-./012356789:;?@ABDEFGHIJLMNOPQRURoot Entry F W1Table4IWordDocument(fSummaryInformation(CDocumentSummaryInformation8KCompObjj  F Microsoft Word MSWordDocWord.Document.89q nokia 9300i dimplex model amesbury revol k800i cad 32 sharp ar-m205 kiev apartments service de luxe 5040.11 thuraya sg 2520 shell dunlup 205 55 r16 kaasi