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DD/ MM/ YY/ Male Female National ID Card No: Company Name: Address (Office / Residence)

1) This document is a membership form for the National Register for Trainers/Consultants (NRT/NRC). It collects personal and professional information from applicants. 2) Applicants must provide details like name, date of birth, qualifications, professional memberships, employment history, training/consultancy experience, and references. 3) They must also select the scope of industries and topics they can support based on their experience, and include an application processing fee with the completed form.

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Maheen Amin
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53 views3 pages

DD/ MM/ YY/ Male Female National ID Card No: Company Name: Address (Office / Residence)

1) This document is a membership form for the National Register for Trainers/Consultants (NRT/NRC). It collects personal and professional information from applicants. 2) Applicants must provide details like name, date of birth, qualifications, professional memberships, employment history, training/consultancy experience, and references. 3) They must also select the scope of industries and topics they can support based on their experience, and include an application processing fee with the completed form.

Uploaded by

Maheen Amin
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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National Register for Trainers/Consultants

( NRT/NRC)
Membership Form

Photos

Please write in BLOCK LETTERS and tick the relevant boxes where applicable. You can use extra column if you require.
PERSONAL INFORMATION
Name (Mr / Dr / Mrs / Ms):
Date of Birth: DD/ MM/ YY/ Gender: Male □ Female □
National ID Card No: - - Designation:
Company Name:
Address (Office / Residence):

Phone: Fax: Email:


INTERNATIONAL / NATIONAL / NPO COURSES ATTENDED Duration Year

Professional Memberships Professional Body Member Since

Educational Record : List most recent educational experience


Years Attended
Qualifications obtained if any
Education Institution Address
listing subjects and grades
From To
a.

b.

□Provisional Trainer □ Associate Trainer □Lead Trainer


Category Type
□Provisional Consultants □ Associate Consultants □Lead Consultants

References provided Yes □ No □


Reference # 1 Reference # 2
Name Name
Company Company
Designation Designation
Contact Contact
Employment Experience : List most recent employment experience
For each previous employment / job experience, please give organization worked for, designation, period of employment and sector (provide job
details in the CV).
Organization Job Title From To Industry/Sector

Organization Job Title From To Industry/Sector

Organization Job Title From To Industry/Sector

Organization Job Title From To Industry/Sector

REGISTER INFORMATION
Please select the appropriate scope from the below mentioned scopes which can be supported by your experience:

Aerospace Mining and quarrying


Agriculture and fishing Non-metallic mineral products
Basic metals and fabricated metal products Pharmaceuticals
Chemicals, chemical products and fibres Public administration
Construction Real estate and renting
Concrete, cement, lime, plaster etc. Recycling , beverages and tobacco
Engineering services Refined petroleum products
Financial intermediation Sales & Marketing
Food products, beverages and tobacco Shipbuilding Food Products
Gas supply Strategic Implementation
Health Services Textiles and textile products
Hotels and restaurants Transport, storage and communication
Human Resources Wholesale and retail trade
Information Technology Water supply
Live Stock Any other (please specify)
Machinery and equipment

Training/Consultancy Experience (Begin with the most recent)


(List only experiences with adult learners). Use additional sheets, if needed.

Course Name Location Year Skill Type


Technical □ Soft □

Technical □ Soft □

Technical □ Soft □

Technical □ Soft □

Technical □ Soft □

Technical □ Soft □

Technical □ Soft □

Technical □ Soft □

Technical □ Soft □

Technical □ Soft □
Technical □ Soft □

Technical □ Soft □
APPLICATION PROCESSING FEE

(Application Processing Fee in full must accompany application, Cheque / Draft / Pay Order payable to National Productivity Organization)
[Tick Only One]

□ Draft / Cheque /Pay Order # Amount:


DECLARATION:

I hereby declare that the information as provided by me in this document is true and accurate. I understand and accept that any false
declaration of information on my part will disqualify me from the membership.

Applicant Signature: ---------------------------- Date: ----------------------

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