<p> STAFF-IN-CONFIDENCE</p><p>2018 ACSC Nomination and Personal Particulars Form Course Name/s: 2018 DSSC</p><p>Course Dates: - 2017 IELTS Prep Cse 13 Mar – 26 May 17 - 45/17 AMF Course 30 Oct – 10 Nov 17 (DITC) - 01/17 ADC Preparation Course 13 Nov – 15 Dec 17 (DITC) - 2018 DSSC Jan – Dec 18 (ADC) Target Course: 2018 DSSC</p><p>To be returned by: 01 Feb 17</p><p>Screen Test Date IELTS-A screen testing will be conducted 0900-1200 each day at IDP Silom during the period 06-10 Feb 16. Which day are you available to attend ? On completion, the form is to be returned electronically to all addressee listed below. DCO - Khun Sawitree Jongsuwat 02 344 6386 [email protected]</p><p>PERSONAL PARTICULARS Family Name: </p><p>Given Names:</p><p>Preferred Name/Nickname:</p><p>Gender: Male Date of Birth:</p><p>Have you attended Defence sponsored No training in Australia? If so, when?</p><p>Have any of your Personal Particulars changed since your last course in N/A Australia? If so, please advise the change.</p><p>Service (Navy, Army, Air Force, Civilian): Corps:</p><p>Rank/Grade:</p><p>Military ID or Service Number:</p><p>CORRESPONDENCE Work address: Home address: Email address:</p><p>Phone numbers: Work Fax</p><p>STAFF-IN-CONFIDENCE STAFF-IN-CONFIDENCE - 2 - Home - Mobile</p><p>POSITIONS Please indicate the positions held for the past 10 years, starting at current posting Year Posting/Position (Job Held)</p><p>COURSES/QUALIFICATIONS Please indicate all local, overseas and civilian courses completed during the past 10 years Qualification Year Course Country (if applicable)</p><p>STAFF-IN-CONFIDENCE STAFF-IN-CONFIDENCE - 3 -</p><p>Target Course Information</p><p>Target Course Name: 2018 DSSC</p><p>Candidate ADFELPS Profile:</p><p>Date of Test: S - L - R - W - *Note this profile is valid for only 12 months and candidates will not be retested for 3 months after test date.</p><p>Example only: Listening 13c Rater: TH 980226</p><p>Speaking Listening</p><p>Reading Writing</p><p>Name and Rank of Supervisor </p><p>Supervisor’s Signature Date:</p><p>STAFF-IN-CONFIDENCE</p>