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Laboratory Technician Questionnaire
Round 1 Data collection and preliminary assessment
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* Indicates required question
Email
*
Your email
Title (Dr, Mr, Mrs, Miss, Ms, Other)
*
Choose
Dr.
Mr.
Miss
Mrs.
Ms.
Surname (Family Name)
*
Your answer
First and Middle Names (where applicable)
*
Your answer
Present Address
*
Your answer
Telephone No Work/Daytime No
*
Your answer
Telephone Number (Home)
*
Your answer
Gender
*
Choose
Female
Male
Marital Status
*
Choose
Single
Married
Date of Birth
*
MM
/
DD
/
YYYY
Place of Birth (City, Country)
*
Your answer
Present Nationality
*
Your answer
Are you a Togolese Citizen?
*
Choose
Yes
No
Are you legally entitled to take up employment in Togo?
*
Choose
Yes
No
Please provide details of any experience/qualification that you have regarding the quality testing of petroleum products:
*
Your answer
Please provide details of any experience/qualification that you have regarding Health and Safety at Work :
*
Your answer
Please provide details of any experience/qualification that you have regarding supervisory/management experience you have :
*
Your answer
Please provide details of any experience/qualification that you have regarding your experience of working with Quality Control Systems (including which standards):
*
Your answer
What is your salary expectation for the position available? (Per year)
*
Your answer
What is your reason for leaving last/current position
*
Your answer
Are you aware that this position requires working a certain amount of antisocial hours?
*
Choose
Yes
No
DECLARATION: I declare that the information I have given is true and complete to the best of my knowledge and belief. I undertake to notify any material changes in the information I have given above to the Human Resource Office. I understand that any false statement or deliberate omission in the information I have given in this questionnaire may disqualify me for employment or make me liable to disciplinary action, which may include dismissal.
*
Agree
Disagree
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