Scribd
Upload
11 views4 pages

FORM

Uploaded by

Tefzen
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
11 views4 pages

FORM

Uploaded by

Tefzen
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 4

ናብ ሓድነት ክፍለ ከተማ ንግድን ኢንዱስትሪን ቤት ፅሕፈት

መቐለ

ዋኒኑ፦ ምሕዳስ ብቅዓት መረጋገፂ ይምልከት።

አይተ ተፈሪ ብሩ ሓጎስ ብዕለት 07/05/2005 ዓ/ም ብፅፈት አመራርሓ ስራሕ አማኻሪ (Quality
Management System Consultancy) ብፍቓድ ቁፅሪ 00002 ዝተመዝገበ ክሳብ
17/10/2008 ዓ/ም ዝፀንሕ መረጋገፂ ብቅዓት ተዋሂብዎም ዝነበረ እንትኾን እቲ ሕሉፍ ዘከናወንዎ ስራሕቲ ቅቡል
ኮይኑ ስለዝተረኸበ ንሳልሳይ ጊዜ ንክልተ (2) ዓመት ክሳብ 12/09/2018 ዓ/ም ዝፀንሕ መረጋገፂ ብቅዓት ምስ
እዚ ደብዳቤ አታሓሒዝና ዝላአኽና ምኻንና ንገልፅ።

ምስ ሰላምታ!

ቅዳሕ
 ንአይተ ተፈሪ ብሩ
መቐለ

TIGRAY NATIONAL REGIONAL STATE SCIENCE AND


TECHNOLOGY AGENCY

Competency Certificate Application form


Applicant personal information (please print or type)
1. Name: ____________________________________________ Sex: _________
Nationality: _______________________
2. Ciity: _______________________________ Region: ____________________________
3. Current License permit No (If renwal): ______________________Agency or
Organization: __________________________________________________________
4. Daytime Telephone Number: _____________________ Alternate Telephone:
_________________
Email: ________________________________
5. Education level: ________________________ Field of occupation:
___________________________________________________________________________________
___________________________________________________________________________________
6. Year of experience in the area of application, as supervised: __________ and as
supervisory: _________
7. Do you have recommendation letter from recognized institute or individual,
Yes No If yes, please attaches the letter.
8. Residence permit No: ______________________________ Work permit
No_____________(Where applicable)

Area of Application (Research Information)


1. Area of application: _________________________________________________________________
2. Life time of the project: ____________________________

Certification:
I certify that the information provided on this application it true and correct and that I will
comply with the terms and conditions of this project, including special restrictions. I
understand that providing incorrect information may result in revocation of my permit or
possible penalties.

Applicant Signature: ____________________________________Date of signature:


______________________

Authorization – TSTA Use Only


Permit No: ___________________________________ Date begins: __________________________
Date ends: _______________________________
MOST Personnel Approval (Print Name): ___________________________________________

Signature: ________________________ Date Signed: _________________________________


TIGRAY NATIONAL REGIONAL STATE SCIENCE AND
TECHNOLOGY AGENCY

Competency Certificate Application form

Applicant personal information (please print or type)


9. Name: Teferi Biru Hagos Sex: Male
Nationality: Ethiopian
10.Ciity: Mekelle Region: Tigray
11. Current License permit No (If renewal): 00002 Agency or
Organization: Tigray national regional sate science and technology agency
12. Daytime Telephone Number: 251914723674 Alternate Telephone:
251924465656
Email: [email protected]
13.Education level: Master Degree Field of occupation: Business
Administration (MBA)
IRCA Certified trained for QMS Auditor/Lead Auditor Ref No A 17338; OSH
Specialist trained and certified from OSH Academy; ESIA trained and
certified from TEPLAUA, Business Development advisory trained and
certified from UNDP; and others as per attached.

14. Year of experience in the area of application, as supervised: 12 years and as


supervisory: 10 years
15. Do you have recommendation letter from recognized institute or individual,
Yes 
No If yes, please attaches the letter.
16. Residence permit No: 4589/ሓ/ኮ/2003 Work permit No_____________(Where
applicable)

Area of Application (Research Information)


1. Area of application: Quality Management System Consultancy
2. Life time of the project: 2 years

Certification:
I certify that the information provided on this application it true and correct and that I will
comply with the terms and conditions of this project, including special restrictions. I
understand that providing incorrect information may result in revocation of my permit or
possible penalties.
Applicant Signature: ____________________________________Date of signature:
______________________

Authorization – TSTA Use Only


Permit No: ___________________________________ Date begins: __________________________
Date ends: _______________________________
MOST Personnel Approval (Print Name): ___________________________________________

Signature: ________________________ Date Signed: _________________________________

You might also like