Mr.

Vasily

2231-11

Systems Administrator

Given Names

Pupkin

Any other names you have used (e.g. prior to marriage)

Private Address

Planet Earth

Telephone xxx-xxxx

Fax

Postcode 03115

Email

x@x.gov.ua

Agents Name

Agent’s Address (if applicable)

Telephone

Fax

Postcode

Email

Date of Birth

Country of Birth

Country of Residence

Members of a recognised computer society (see Requirements for Assessment) should state society name, grade, membership number below:

06 nov 1978

Ukraine

Ukraine

Skills Assessment fee: $350 RPL Assessment fee: $400 (Fees may vary, see Requirements For Assessment)

TOTAL FEE: $350

METHOD OF PAYMENT

Cheques should be made payable to Australian Computer Society. Please enclose with your application. If payment is by credit card, please complete the details below.

Card Number

Вот этого я не скажу

CVV2

точно

Bankcard

Amex

Expiry Date

J

Name on Card

J

MasterCard

Cheque

I authorise the ACS to charge the amount shown to my credit card.

Visa

ü

Cash **

** Do not send cash by mail

Signature

TERTIARY QUALIFICATIONS: Documentary evidence of your academic record issued by the educational institution(s) must accompany your application. You will need to provide an original certified copy of your academic transcripts and testamurs.

Qualifications

Date course completed

Date qualification awarded

Name of institution/awarding body

Sun Certified System Administrator for Solaris 8 Operating Environment —SCSA

15 march 2002

Prometric certification center Kvazar-Micro, Kyiv

Course SA-238: Solaris 8 System Administration part I

23-27 December

Kvazar-Micro, Kyiv

Cisco Certified Network Associate — CCNA

01 feb 2002

Prometric certification center Kvazar-Micro, Kyiv

Microsoft Certified Systems Engineer

15 oct 2001

VUE certification center Lanit, Kyiv

Certificate of Master’s Degree with honours, — 1999 of Internal Affairs

13.07.1999

13.07.1999

Kyiv Institute of Internal Affairs of National Academy of Ukraine

PC operator

15 nov 1991

15 nov 1991

"Effect"Kirovograd

Was the qualification/s full-time or part-time? both

Normal length of full-time course (years or semesters) including project/thesis/practical training etc from 1991

The time in which you took to complete the course

SUMMARY OF RELEVANT EXPERIENCE AND POSITIONS HELD: (complete this section and attach a resume showing positions held, periods for these positions and details of responsibilities and relevant IT experience).

From Mth/year

To Mth/year

Organisation

Position

MODL Nomination

Details (responsibilities etc.)

oct 2001

present

Firm A Kyiv

Chief of IT department

Yes

30 branch offices, Windows 2000 domain, Solaris 8, Cisco Equipment,

feb.2001

oct 2001

Firm B Kyiv

System Analyst

Yes

Research of network infrastructure of information centre of Ukrainian State Department of Justice and consulting reconstruction of corporate network based on Microsoft Windows 2000 network infrastructure

jul 1999

feb 2002

Firm C Kirovograd

System Administrator

Yes

Head network engineer and main project manager of implementing the regional network infrastructure on the basis of Microsoft Windows NT 4 Server

sep 1995

jul 1999

Firm D

assistant of the Department of Information Technologies

Network and users Support. Was responsible for installing OS and other user and systems software on clients PCs, systems cleanup, defragmenting of a HDDs, antivirus protection, adjustment of network and application settings, troubleshooting, etc.

CHECKLIST (Please tick appropriate answer)
Have you included a copy of your birth certificate/passport/Australian visa?					Y [ü ]	N [ ]
Have you attached payment?					Y [ü ]	N [ ]
Have you included your testamur and transcript?					Y [ü ]	N [ ]
Have you included employer references?					Y [ü ]	N [ ]
Have you included a resume?					Y [ü ]	N [ ]
Have you included (if appropriate) official translations?					Y [ü ]	N [ ]
Have you included (if appropriate) letter of completion?					Y [ü ]	N [ ]
The Australian Computer Society (ACS) has created a Privacy Policy and guidelines to guide our relationship with our members, prospective members and any other individuals having contact with the ACS. The Privacy Policy can be reviewed on our website at www.acs.org.au. Your application will be assessed according to the contract held between the Australian Computer Society and the Australian Government. It is normal practice for the ACS to release part or all of the information collected to the Australian Government for migration purposes. Skill Assessments are not an assessment of a person’s suitability for employment, the quality of their work or the likely success or otherwise of obtaining Australian residency status.   PLEASE SIGN THE DECLARATION BELOW: I declare that all information provided in this application is true and correct. I authorise ACS to make any enquiries necessary to assist in the assessment of my application.
Signature
Date
APPLICATION TO BE SENT TO:
AUSTRALIAN COMPUTER SOCIETY PO BOX Q534 QVB SYDNEY NSW 1230 AUSTRALIA		OR		AUSTRALIAN COMPUTER SOCIETY LEVEL 3 , 160 CLARENCE STREET SYDNEY NSW 2000 AUSTRALIA