US. Deparment of Stat ova arerovas no eso APPLICATION FOR EMPLOYMENT AS A ome LOCALLY EMPLOYED STAFF OR FAMILY MEMBER seiner cea! {his potion sor postions reented by te U.S. iisson under be Ctice of Gvartens Erploymonts imarogony Local Enpionren Recto Ply) POSITION 1.Posion Tile CULTURAL APrmes—ACADE Re EXCHANGE [2 Grae Avs Hunn] CooRarA Tok 3 Vaca Amourcrert Naber 1 Dat vaio fr Wo nmap) Ithsy 1u[aor> PERSONAL INFORMATION 5 Last Nane(ySurnamos Fist Name Widde Namo NDEKIAWaA Dov ce 6. Otfer Nemes Used aie aaah PO Box i2sF3, ay Aare eng gil Tan tanin woe OP CF EEE HI 9. Emel Aadross oy cendlekirwa @ goracl: com [70-Are you 8 US. Cizen? Dw Hv "Do rovhave pemareUS Renters Gooner? E] yee BZ] we yes, provide numbor. ‘2a, US. Social Secunty Number (or US. Cttzons/Permanent U.S. Residents) ‘nde ‘2b. County Identfication Number 13, Ar yu egal eligible to work inthis county? five Cle tyes, Mission HR may require verfiation of eligbilly. lease atach copies of al dacumeraton that confirms your lgalligily to work inthis county (ea, work port residency parm) ‘4. 1you ar appying for a poston that includes crving @ U.S. Goverment vile, do you have a erent and vad Grvors icense? Cre no 1 natarctcatie tyes, Ciase/Type of License 1 yes, nave you operated a vehi whut incident forthe past roe yours? Ove Wn 8.174 Page 1 0f6 05.2016| 15.wnat days are you evatebe lo work as pat of a eguary scheduled work wook? (Check a tat apply) Oy sureey (Z] memcay —(Z] Tuescay —(Z] wecnasday [2] Twurcsy (7) Frdey satay 16, Dosny of yours crmaber ofyou household workerthe Und Ses Gomes?” EJ ver BQ) no '1yes, provide the deals below. i you need more space, use an adllonal sheet of paper. (See Insracton fr Completing the DS-174 forth defnivon of relatives and members of ousehotd) Name Relationship ‘Ageney, Pealon, and Location U.S, GITIZEN ELIGIBLE FAMILY MEMBER (USEFM) AND U.S. VETERANS HIRING PREFERENCE 1 ‘Are yu csiming prelerencein hing under U.S, law and policy based upon you status as aera U.S. Cizen Eigbe Famiy Member (USEFM) U.S, Veteran? See Instructions fr Completing the DS-174 for additonal infomaton about the USEFM ane U.S Veterans hing artes (Check ony one.) (1 US Cts erm vs veteran 1 us. cen FM and aso US. Veteran. {Z] Neier Us. citzon EFM, nora US. Veteran Have youvokedis reterence ora prerpoeion ahs postition? «vos Z} No iyes, when ageney? Date (nm-ttyynn) {aiming eget for U.S. Veteran preference, you mus alach a copy of your most racatDD-214, Cerificate of Reloase or Discharge tom Active Duty. I claiming conctona gibi for US. Veterans prefrenca, you must submnt proof of condlcna sss EDUCATION. 18. Graduate Schoo! Dates Attended Di you Degree/Dipioma | Major Subject, Name of Scoot Cty, State or County ‘mr | gro - | masreer oF UNWEESIY Ge IRinga | FeO 20% | ve | DEGLEE | Aer te Tuten cuuTaae sed oy, 201 No is toNoM, 2016) 1] caniea ‘Unierrsine Colegturvesiy Deis Atenas | Okgyou | DegrotDoione Tajo Subject Name ot Sooo hy, State or County ‘romrpy) | grader ql nl From C2017 | gacuetes oF Mid UNVERNTY 6 LRINGA eee Bee deqace een to Sul _2ely | ArT nesP Ley Ae Toweum Hah SchoolGED or Cour Eauvlot Date Aterdee | Daou ifr highest grace evel completed Name of Soo. Cy ite oF County mm | orca i From MAE 200 yes | Diviseors THeee Kokohwe GikLS foe | Ml (B20 | Dw ‘ther eg TosticaVocatonl Schoo! | Dates Aterses | Deyou | CanonDipiona | WabrSutoe Name ot Schoo, ty, State or County (myn) — | race? ss ii ae CERT FCAT 5 elon From JAry 20 a AKoANRUA SélONDALY z Hv | oe seconnany Sepa to 07 298 | OO | Hucatw stra Page ot 05-201619. Listyour languages. tne appropriate competency levels, and yout pemayiratspokeninatve language using the language standards below. You may only dently one primaryirtepokerinatve lorguage. Level. Professional Traneiatorintrproter Language Leva Speak Feed Wie Primary ENGL H w w Ww Cwarie iS ry VW FRERLH t ‘ q WORK EXPERIENCE 20, Include al work experience, pad and voluntary. Start wih your present or most recon! work exprience. When describing work, a specie Autesesponsbiltes and accomplishments. Include supervisory responsblis and tre qumber of employees supervised. Go into as much det as posstie for work experience that direct relates tothe advertised postion. include al prods of unemployment and the reason, (Use edna! pages, as needed) 1203. WORK EXPERIENCE 20a. Job Tite (U.S. Govemme,iclude the series and grace) REEBROH ASH STANT AND AdMINUTeATI VE SECRETARY From immynn) | To (omen) ‘Salary per Year in U.S. Daler or Local Gureney | Hous per Week et gory | bec gore 3600p Gores Employers Nome and Aderess Super sors Name and Caria ormaton FetAk YET Cultura peeTeT ia DAN Kuewee Ba. Box 200, ProneNunber 07 62 #2 46 42 IRDA Gpevlanin [Email Adaress jan Pucver@ fabanyetu nef Ware you a superior is poston?” 7] Yes EZ] no May WR conc your supervisor? Yeo [] No tyes, now many people id you supowise? ‘Dessree your mar aiesresponsbiiis anf eczomplshments : peonluchny researeber and making evaluution 4 Pryet atwilas Laaiching pred manager 1s Sine adininithahive achvibas b fo hos ‘ith other lquer we boc folly neanaged Ar renovals the AS Grain building iste Kegiiraf Mile nissen nx ason() fr Leaving (Do not writs "NA" or “ot apolicabio") = The ppd phased ond, Me pred Was gue @Ainctd Gane fave tibet was only pyr s.174 age 206 os-20%6ec ices * 200. WORK EXPERIEN( |20b. deb Tile (TUS. Goverment aude the sores and grace) | Resennce Asnsiani Ciricensie Fron ¢nmoonn) | Ta frm) ‘Salary per Yearin U.S. DalavsorLocal Curency] Hous par Wook may Rois | Fut 201r qq0 4d (2 mention ony) | Gores TEmpoyers Namo andAszress [Supenisors Nome and Caras ntrmaton WD EE ConseRveriory socsETy (Wes) Name thao RuTABAW TRA peo Bex [6Sb, ProveNunber_ OW Sle 62r IBINGA, Tanrnara Emel Ades Tharsllnata ban tibwn © gm com a RO Woy FR concur spanner? ves] Wo yes, now many people you spore? ee tanh re one = | beconducting hruge wild Survey within Me villages gucrous KATA Veationad Darks» iain The main agents wis be agen tte awanney bf the community tuards | eavirrmentel Contervalleia | Reason(s) fr Leaving (Do nt write "WA o "ot applicable") 1h was pat an teteentha? progam fer the purpox dy bearmeay sad gaining “navre experianee - fg RUMUA aad : : 1206. WORK EXPERIENCE, 20e. JOD Tie (Y'U.S. Government, cue the sores and grade) Tour Guide ‘From (mm-yyyy) To (mm-yyyy) ‘Salary per ear in US. Dollars or Local Currency ‘Hours per Week SET 203 | SEC 208 ones nose? Nome ond Across | Supanisors Name and Const inermation ULvamiu rude heTEhve te Name ELieaaiK mega Pree wlegun@ nal ne meer PhoneNumber 0 26? 2I7P AE phe: 2601221 (0 621/p aa, ; Wor yeu aspenisorm iS PesIOr? vex [no May HR contact your supereo? 77 vex Eno yes, now many people did you supervise? ‘Desenb yourmajcutesosponsbliios and accomplishment. | Pasticapated iin enviroanrectad OF Uluguer nralane reserves Convery and Mur guide activities Reason(s) for Leaving (Dot write "WA" or “not apacabe") KH was fed thedg Conductel for 2 prot Page 4 of 6‘20d. WORK EXPERIENCE 21d, Job Tile (U.S. Goverment, include the series and orace) TEACH From tmmvon) | To tnmeen) ‘Seley pr Vearin US. Dolev Laval Carancy | Hous par Weak Ape 2oit_|sée7T 20) | j200900 Thy Ho Hes Employers Nem and Adress Supenisors Name and Contact norton AKHERI Voc iiuwac Tet wiv Name JOR SHERVAG WA Pre. B04 Qo0u4, ProneNutber OFS PP 0y Ze AkecHp, Fan rpnia Enna he Serny of ajncule @ gmail Comm WeeOUa ONSTAR HIE? TA vay) ne MarR coat yor superar! vey FT no yes how many pooped ou superise? 2 Deserbeyur mah dee eezanabils and acronpishnens | Teeclueg and Fupervining Shu leh J Aakewnif ant pracy Exanranutices | Reason() for Leave (D0 nat wt "NA “nt opoeabe") i weet fe foterr Shadiés LICENSE, SKILLS, TRAINING, MEMBERSHIP, AND RECOGNITION 21. Uist rcessionaltensae,coreatos, typing/eyboard sls, compe sis, rma and oie reining, and ae ks a abies you conadar relevant othe poston Inu tach copy ithe Icense or cartfealion ea requirement ofthe poaton carson the US. plete lit testi of issuance. Kensed mn ancther cou, ease le provineltataegion ans county eee, se ~ telewrihy raring ~ Computer Pifhuare and cag wtateois lonrte ~ Fenngee oprah ily aud eubseprerenrttap paimig 22 Uist polestoral aganizatons, ttocatons vars, bono lelawahips ard puicators you cose can - Pablicatisin COnsheied labour eeadenuia edu) Melton Mandeh Afrtan (whhcte QB Seucss ant Tecan degy Codhifitaboi) - Univerity of Dar es Salaam ( Certification) REFERENCES 23, Uist tree persona references who ee nt relatives oF former supervisors who ean speak krowledgeably of your work perlomance. Name fesroee : Telephone Occupation Timson SAWGe | Po Box 200, (KINGA [OWI 975333 lems Lehane Peien kasime | Po Bet gw, (Ringa | ore 25 ee4lbonie roi ey Kistinrsun Fenemey p-0- Bor Fo70, Bim 0783 esr | Engineer | ‘SIGNATURE AND CERTIFICATION 24 | cert that othe bes of my knowlege and bale, al ofthe information on and attached to this applcton is tue, coved, complete, end mede in 22a. | understand hat fase or raucuentinfonmation on or atachedt ths applcabon maybe groune for noting ee emrinaton/damissa afer | bepin work and may be punishable by foe or Imprisonment according otis coureys ewer W's low | understand that ‘any infrmaten | voluntary provide on or atached ta this application may bo iwestgatoe Sonate Date amon) Abey-? ot /ro[ 2017 « os.t74 Page Sore 052016‘CONTINUATION - WORK EXPERIENCE 20_, Job Tile (U.S. Government, include he sores and grace) From fmmyn | Tommy ‘Salary per Yoar A US. Dolars or Local Gurney [Hours per Weak Employers Name and Adress ‘Supervisors Name and Contac infermation Name Phone Nomber ea | Ennai Adress Ware yous sopenisarin bi peeEN? Tye. Eno May HR contact you sparse? TT ven Eno yes, how many people id you supers? Deserbe your major duesresponstities and accomplishment, Reeson(s) fr Leaving (Dot wnte "WA 6 “pot appcabe") ‘CONTINUATION - WORK EXPERIENCE 20_, Job Tite (US. Government, clude the series and grade) From immo) | To(mmyny) ‘Salary per Vearin US. Dallas or Local Curaney | Hours per Week Enployers Name and Adress ‘Supervisors Namo and Contact information jomber Wee yous sparisormTNBPOSION? ven] no Ityes, now many peope dis you supervise? May BR conser supe? yay Ow Describe you major dutesrespenabiies ang accomplishments, ‘Reason(s for Leaving (Do not write ‘WA or “rt apaleabe) beara 052016 Page 6 of