HealthNet TPO Application Form

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HealthNet TPO/Afghanistan

Applicant Data Sheet


Full Name: Esmatullah Azizi Position Desired
Father’s/Husband’s Name: Haji Abdul Ahad
Address: Farah- Qalah Arbab
Tel. # (Work) (+93)790126434 Res. Mob. (+93)704216064
EMPLOYMENT RECORD
Dates Reasons for
Employer's Name & Address Position(s) Held Gross Salary
From To Leaving

B1Dec-22 B1Aug-23 War Child UK- Afghanistan/ Herat Caseworker 25000Afs End of Contract
B1Apr-22 B1Nov-22 WADAN GPE Project/ Farah Community Mobilizer 18000 Afs Promotion
B1Sep-19 B1Oct-20 Refah Technology Company/ Kabul Agent 15000Afs Promotion

EDUCATION RECORD
Period Division/
Name of Institution Examination Remarks
From To Grade
Abu-Nasr University B1Nov-21 Successfully Passed A+ Grade
M.Nader Aubi High School B1May-16 Successfully Passed B+ Grade

COMPUTER SKILLS
Ms. Word Professional Ms. Excel Professional Ms. Professional
Outlook Professional PowerPoint

PROFESSIONAL TRAINING RECORD RELEVANT TO APPLIED POSITION


Name of Period
Type of Training/Course Remarks
institution/Organization From To
War Child UK Afghanistan B111-Jul-23 B113-Jul-23 Case Management SOP Training
WADAN B121-May-22 B129-May-22 Child Safeguarding, CP, PSEA
CCNPP-MRRD Training
B18-Feb-21 B19-Feb-21 REACH Social Mobilization Workshop
USAID B128-Nov-17 B129-Nov-17 Community Moblization Training
Are you prepared to work any where in Afghanistan? YES/NO

Are you involved in any litigation outstanding agaisnt you? YES/NO ☑

If yes, details please:

May we approach your previous employers? ☑YES/NO

Please give detail of other benefits offered by your present/last employer and their approximate value
(Including Medicine & Excluding Bonus)

Do you have any relative working in this or any of the HealthNet TPO Afghanistan offices? YES/NO☑

Name Location Designation Cantact detail Relationship


Indicate whether slight/fair/fluent Major accidents/illnesses with date
Languages
Spoken Read Written
Occasion____________Rsult______________________
Pashto Fluent Fluent Fuent
Dari/Farsi Fluent Fluent Fuent
English Fluent Fluent Fuent

References: (Please list three references of your last/present employers)


Name Designation Organization Contact # Email
Mahmood Farootan Case Management TechnicalWar Child UK Afghanistan 795171156 mahmoodfr@warchil
Benyamin Barez Project Manager WADAN 703895202 pmgpe.farah@wadan
Muhammad Qalandari Chief Executive Officer Refah Technology Company 798154114 m.qalandari@refahte
DECLARATOIN
I hereby certify that the answer given by me to the foregoing questoins are true, corrrect and without any consequential ommissions what-so-
ever. I agree and clearly understand that in the event of my being employed in any office of the HealthNet TPO, if it is found that any statement
or information mentioned above in this application form is untrue or false, the same shall be sufficient cause for termination / dismissal of my
service from the Company in accordance with law.

SIGNATURE: __________________
DATE: _______________________
(Signature isn’t necessry while you are sending the form, you are asked for signature when you are short listed).
[email protected]
[email protected]
[email protected]

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