Application Form
Section A
Please complete this application form and return it along to [email protected]
Post applied for: Laos Country Representative
How did you hear about this vacancy?
Salary expectation:
Personal Details
Surname/Family name:
First name(s):
Address:
Contact details: Mobile:
Skype ID:
Email:
Nationality:
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Application Form
Section B
CAREER OVERVIEW
How many years’ experience do you have of providing strategic leadership for programmes in insecure or
sensitive country contexts?
0 - 2 years 3 – 4 years 5 - 7 years 8 or more years
How many years’ experience do you have of developing programmes and successfully engaging donors?
0 - 2 years 3 – 4 years 5 - 7 years 8 or more years
How many years’ experience do you have of managing partners?
0 - 2 years 3 – 4 years 5 - 7 years 8 or more years
How many years’ experience do you have of financial management of programmes and of overseeing
financial operations?
0 - 2 years 3 – 4 years 5 - 7 years 8 or more years
How many years’ experience do you have of overseeing operations (HR, facilities, policy, legal,
safety/security)?
0 - 2 years 3 – 4 years 5 - 7 years 8 or more years
Present or last post
Name and address of current or most recent
employer:
Telephone number:
Date of appointment to organisation (DD/MM/YY): From
To
Job title:
Contract type: TEMPORARY PERMANENT
Type of appointment: FULL-TIME PART-TIME
Salary details:
Reason for leaving:
Notice period:
Please describe key responsibilities of your
present/recent role:
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Previous Employment
Please list your employment history, including any relevant voluntary work in the last ten years (starting with
the most recent). Please include the country you were based in if different form the organisation’s address.
Name and Start End Reason for
Detail of your responsibilities
address of Date Date leaving
employer (mm/yyyy) (mm/yyyy)
(add extra rows if necessary)
Please use the space below to give a summary of other relevant roles/notable achievements in
the rest of your career:
Languages (written and spoken)
First Language:
Other languages (please list) Written Spoken
level of fluency level of fluency
1. Basic/Intermediate/Advanced Basic/Intermediate/Advanced
2. Basic/Intermediate/Advanced Basic/Intermediate/Advanced
3. Basic/Intermediate/Advanced Basic/Intermediate/Advanced
IT & digital skills
Project/Programme
management/Database / software
used? Other relevant IT skills?
Digital facilitation/group working
systems skills?
Experience with MS Office software
(excel/word/powerpoint/One
Drive/SharePoint/Teams etc)?
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Education
Date from Date from Place of training Examination
Subjects/Course Taken
(mm/yyyy) (mm/yyyy) school/college/university Results/Grades
(add extra rows if necessary)
Other Experience Relevant to the Post e.g. Work Experience, Voluntary positions
Referees
Please give the name and address of two people whom we may contact for a reference. One of
these should be from your current or most recent place of employment, although Cord reserves
the right to contact any of your former employers.
Recent Employer - 1st Referee 2nd Referee
Name
Position
Organisation
Relationship
Address
Telephone number
E-mail address
Can we approach prior to
YES NO YES NO
interview?
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Application Form
Section C
Post Applied For: Laos Country Representative
Please complete the following sections, using additional space if necessary.
1. In no more than 500 words, tell us why you are interested in working for Cord and why
are applying for the Laos Country Representative role.
In no more than 1,000 words, tell us how your experience will enable you to fulfil the
key responsibilities of the role that are outlined in the Laos Country Representative
Recruitment Pack.
2. Please refer to the Knowledge, Skills, and Experience sections, and personal qualities
(from the You’ll need section) in the Laos Country Representative Recruitment Pack
and clearly demonstrate how you meet these requirements of the role.
Please provide as much evidence as you can to illustrate how you meet the criteria.
In no more than 500 words please provide details of your experience of providing
3. leadership, modelling values and building inspirational organisational culture.
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In no more than 500 words please provide details of your experience of influencing
stakeholders to take sensitive and informed action and of engaging donors to commit
funds.
4. Please provide details of outcomes arising from your actions including details of donors
you have successfully engaged (with detail about what you were responsible for, which
donors, budget size sector focus)
In no more than 500 words please provide details of your experience of financial
5. management (including budget responsibility) and operational management (HR,
facilities, safety/security)
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Application Form
Section D
Data Protection Statement
Information from this application may be processed for purposes registered by the Employer under the
Data Protection Act 1998. Individuals have, on written request [on payment of a fee] the right of access to
personal data held about them.
I hereby give my consent to Cord processing the data supplied in this application form for the purpose of
recruitment and selection.
Cord may also use the information you provide to keep you informed of other vacancies within Cord. By
signing this application form you consent to these uses.
If you are applying for a post where you will be required to work closely with children, young
persons or vulnerable adults or that brings you into contact with finance and money, relevant
checks may have to be carried out as applicable in the country where the post is based. Any
offer of employment is subject to satisfactory references and checks.
The information you provide on this form will only be used in accordance with the principles of Cord’s
confidentiality policy. If you are appointed, it will form the basis of your personal record.
Consent Agreement
I certify that all information provided on this application and attachments are true and correct, and that
any misstatements or omission of material facts in the application or the recruitment process may result in
disqualification, or termination of employment. Positive Reference Checks, including Police checks (if
applicable) are an integral part of our recruitment process. Offers are conditional to satisfactory references
and police checks.
I hereby authorise the individuals, companies, agencies or institution that I have provided as references
and/or mentioned as previous employers in my curriculum vitae or resume to furnish Cord or its agents
with any information it may have concerning me which is on record or otherwise, and do hereby release
the addressed individual, company, or institution and all individuals connected therewith, including Cord to
which I am applying, from any and all liability for any damage whatsoever that may be potentially incurred
in furnishing and disclosing any information relating to and/or relevant to my employment with the
addressed individual, company, or institution. This simply means that I will not sue the addressed
individual, company or institution for disclosing any requested information concerning my previous
employment
Signed: Date:
Please return your completed application by email to [email protected]
If returning this application electronically you are confirming that the information is true and
accurate to the best of your knowledge.
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