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Apellido Paterno Apellido Materno Nombres
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DIRECCIN ACTUAL
Direccin Domiciliaria: Av./Jr./Calle/Nmero/Interior Referencia
FORMACIN ACADMICA
Estudios Estado Folio(s) Fecha de Egresado Folio(s)
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Pgina: 1 de 5
HOJA DE INSCRIPCIN ELECTRNICA
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Institucin Cargo Experiencia F.Inicio F.Final Tiempo Folio(s)
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Institucin Cargo Experiencia F.Inicio F.Final Tiempo Folio(s)
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Institucin Cargo Experiencia F.Inicio F.Final Tiempo Folio(s)
SERVICIO DE ELABORACIN DEL PLAN DE GESTIN DE RIESGOS DE LA GERENCIA DE DESARROLLO ECONMICO, DISTRITO DE
INDEPENDENCIA - HUARAZ - ANCASH
Institucin Cargo Experiencia F.Inicio F.Final Tiempo Folio(s)
FORMULACIN DEL ESTUDIO DE PRE INVERSIN A NIVEL PERFIL DEL PROYECTO INSTALACIN DEL SISTEMA DE SANEAMIENTO BSICO EN
EL CASERIO DE LLANCA, DISTRITO DE PIRA - HUARAZ - ANCASH
Institucin Cargo Experiencia F.Inicio F.Final Tiempo Folio(s)
FORMULACIN DEL ESTUDIO DE PREINVERSIN A NIVEL PERFIL DEL PROYECTO INSTALACIN DEL CANAL DE RIEGO RUMICHACA UCNA EN
EL CASERIO DE CALLANCA, DISTRITO DE PIRA - HUARAZ - ANCASH
Total EXPERIENCIA COMPROBABLE EN EL SECTOR PBLICO O PRIVADO, MNIMA DE DOS (02) AOS 2 aos 0
meses 30
das
Institucin Cargo Experiencia F.Inicio F.Final Tiempo Folio(s)
Pgina: 2 de 5
HOJA DE INSCRIPCIN ELECTRNICA
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Institucin Cargo Experiencia F.Inicio F.Final Tiempo Folio(s)
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REFERENCIA LABORAL
Institucin Cargo F. Inicio F. Final Nombre y Apellidos Telfono Correo
Pgina: 3 de 5
HOJA DE INSCRIPCIN ELECTRNICA
REFERENCIA LABORAL
Institucin Cargo F. Inicio F. Final Nombre y Apellidos Telfono Correo
CAPACITACIN REQUERIDA
Institucin Descripcin Materia F.Inicio F.Final Folio(s)
CONOCIMIENTO
Descripcin Opcin
REQUISITOS GENERALES
Descripcin Opcin Folio(s)
HA SIDO DESTITUIDO O DESPEDIDO DE OTRA ENTIDAD Y/O EMPRESA, POR CAUSA JUSTA No ------
RELACIONADA CON LA CONDUCTA Y/O DESEMPEO.
HA SIDO SANCIONADO CIVIL O PENALMENTE, COMO RESULTADO DE UNA ACCIN DE CONTROL, No ------
CON RESOLUCIN FIRME.
HA SIDO SANCIONADO POR FALTA GRAVE DISCIPLINARIA EN PROCESO ADMINISTRATIVO O No
INVESTIGATORIO, CUYO IMPEDIMENTO SE EXTIENDA HASTA POR CINCO (05) AOS CONTADOS ------
DESDE LA IMPOSICIN DE LA SANCIN.
RENE EL PERFIL PROFESIONAL O TCNICO ESTABLECIDO PARA LA PLAZA A LA QUE POSTULA. Si ------
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HOJA DE INSCRIPCIN ELECTRNICA
REQUISITOS GENERALES
Descripcin Opcin Folio(s)
IMPORTANTE
La informacin contenida en la Hoja de Inscripcin Electrnica tiene carcter de Declaracin Jurada, para lo
cual la Contralora General de la Repblica tomar en cuenta la informacin en ella consignada, reservndose
el derecho de llevar a cabo la verificacin correspondiente; as como solicitar la acreditacin de la misma. El
postulante se somete al proceso de fiscalizacin posterior que lleva a cabo la Contralora General de la
Repblica. Si el postulante oculta informacin y/o consigna informacin incompleta o falsa ser excluido del
proceso de seleccin de personal. En caso de haberse producido la contratacin laboral, incurrir en comisin
de falta grave y se iniciar el procedimiento correspondiente, con arreglo a las normas vigentes, sin perjuicio
de la responsabilidad administrativa, civil y/o penal, que se pueda interponer al respecto por parte de la
Contralora General de la Repblica, reservndose el derecho para tal efecto.
Usted debe guardar la Hoja de Inscripcin Electrnica para presentarla en el momento que le sea requerida.
Las celdas vacas de la columna Folio(s) deben completarse manualmente, al momento de presentar el
currculum vtae documentado.
FIRMA
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