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Instructions:

EMPLOYMENT APPLICATION FORM




OFFICE USE ONLY
Please complete all sections as thoroughly as possible, even if you are attaching a resume.
It is necessary to provide complete information, as this will be used to determine
eligibility.
A separate application is required for each position/vacancy. Application must be received
at the appropriate location by the closing date indicated in the advertisement.
DATE RECEIVED

POSITION INFORMATION

POSITION TITLE, MINISTRY AND LOCATION



FOR GENERAL APPLICATION Full time Part time
Indicate () the type of PERMANENT
Employment you are requesting TEMPORARY
TYPE (s) OF POSITION- please describe


PERSONAL INFORMATION
LAST NAME FIRST NAME INITIALS

Mai Lyndon L
RESIDENCE TEL. NO.
601-2660

DATE OF BIRTH
(DD MM YY)

28/06/1993 BUSINESS TEL. NO. or message
GENDER: Male/Female
Male

MAILING ADDRESS CITY DISTRICT POSTAL CODE

#4 Welch Street Belize City Belize


LEGAL STATUS TO WORK IN BELIZE
Documentation may be required
Belizean Citizen Permanent Resident

Work Permit OTHER please specify

Do you have a disability that
may require accommodation
in the work place

YES
NO
If YES, what
accommodation would
you need?


CURRENT EMPLOYMENT STATUS
Are you currently an employee in the Public Service of Belize?

NO YES If yes, indicate status and provide
Social Security No.
Employee S.S. No.


000473517
Are you willing to work anywhere in Belize? NO YES list locations preferred

EDUCATION AND TRAINING

Please describe secondary, post-secondary, courses and training which have given you work related knowledge and skills. Start with highest level achieved
and specify the degrees, certificates or diplomas completed. Official documentation may be required. Attach a separate page if necessary.
NAME OF INSTITUTION OF
ORGANIZATION
LOCATION YEAR
TAKEN
AREA OF STUDY GRADE/CERTIFICATION/
DIPLOMA/DEGREE
Saint Johns college Belize city 2006 - 2010 Biology and Chemistry Diploma
Saint Johns college junior col. Belize city 2010 - 2012 Biology and Chemistry Associates Degree

SKILLS/EXPERIENCE
Please list areas of experience that you have which are relevant to the position you are applying for and attach any appropriate documentation.

Ability to independently make appropriate decisions while processing a wide range of information. Being well organized I am
able to pay attention to details, remaining on task with multiple interruptions and retaining information. Able to outstandingly
perform varied duties assigned.

APPLICANTS SIGNATURE:

Please read carefully before signing. This application is not valid unless signed by the applicant.
In accordance with the Public Service Regulations for Public Service Employees, to avoid potential conflict you may be required to
provide information about direct relatives or persons with whom you share a household who are employed in the public service.

I certify that the information provided in this application or attachments/resume is true and complete. I understand that if any information in
this application or attachment/resume is found to be untrue or incomplete, my application may be rejected or I may be dismissed in the event that
I am the successful applicant.


X L.Mai DATE 6/6/2014

SKILLS/EXPERIENCE
Please list areas of experience that you have which are relevant to the position you are applying for and attach any appropriate
documentation.
Data entry clerk at court 8
Attain court hearings to record and transcribe details into written copies
Arrange and schedule court date as requested by magistrates
Keep records and preserve the courts seals and records
Inform witnesses, and plaintiffs about the court date
Process warrants and petitions
Customer Consultant at Protel BPO
Analyze customer service requirement and inform of all available services.
Administer all customer orders; provide appropriate consultation to customer for various products and services.
Manage all customer issues and resolve all complaints effectively.

SPECIAL ACHIEVEMENTS
Briefly summarize your knowledge and major skills/achievements which relate to the advertised position or if this is a general application,
to the position(s) that interest you. You may use this space to enter other information you would like us to consider in reviewing your
application.

Well-versed with modern technology and able to adapt to the work place.
Efficient in work processing applications, bookkeeping, and basic management system
Highly flexible and adaptive to new technology
Excellent communication, management and organizational skills
DRIVERS LICENSE INFORMATION
Provide the following information if applying for a position where driving is a requirement.

List class(es) of valid drivers license List any restriction/endorsement definitions
on license.
If required, do you have access to a vehicle
for use on government business?

YES NO

Class A None


REFERENCES
Reference checks will be conducted to assess your past work performance and may include checks of attendance records.

In addition to the references identified in the Work History section, you may wish to provide further references. If any references have
known you by a previous (different) name, please specify.

NAME TEL. NO. RELATIONSHIP NO. OF YEARS
KNOWN
Stephanie Gillett 227-7164 Former Co- worker 2
Adolph Lucas 662-4998 Family Friend/ Co-worker 7
Captain Eric Neal 635-2492 Family Friend 6


APPLICANTS SIGNATURE:
Please read carefully before signing. This application is not valid unless signed by the applicant.
In accordance with the Public Service Regulations for Public Service Employees, to avoid potential conflict you may be
required to provide information about direct relatives or persons with whom you share a household who are employed
in the public service.
Your signature on this application form is your consent that as a condition of being considered for employment in the
public service, references about past work performance will be obtained from your current and previous employers. If
you are not presently employed in the Belize Public Service, you will be notified prior to contact with your employer.

I certify that the information provided in this application or attachments/resume is true and complete. I understand that if any
information in this application or attachment/resume is found to be untrue or incomplete, my application may be rejected or I
may be dismissed in the event that I am the successful applicant.






X L. Mai DATE 6/6/2014