Part 1 申請人填寫 To be completed by the Applicant

姓名 (根據身份證明文件) Name (as per Identity Card)	(中文 in Chinese)
(葡文/英文 in Port / Eng)
澳門居民身份證號碼Macau Resident ID (BIR) No.
地址Address
流動電話 Mobile Tel	電郵 Email

最高學歷 Highest Education Level

大專 Advanced Diploma	學士 Bachelor	碩士或以上 Master or above	其他 Other
學科 Specialization	學校 University

專業認證 (如有) Professional Certification (if any)

名稱 Title	1)	2)	3)
4)	5)	6)

職業 Occupation

全職學生 Full time student	自僱/在職人士 Self-employed/employee	其他 Other:

附上以下文件副本 Copies of documents attached

澳門居民身份證副本 Macau Resident Identity Card (BIR)
最高學歷證書副本 Education Certificate (highest)
個人履歷 Resume
M1 職業稅–第二組 自由或專門職業人士開業申報書 (適用於已在財政局登記為自僱人士者) M1 Salaries Tax – Group 2 Self-employment – Liberal or Specialized Profession Initial Registration (applicable to individuals who have already registered at the Financial Services Bureau (DSF) as self-employed

申請人聲明 Declaration by the Applicant

本人已閱讀澳門生產力暨科技轉移中心(CPTTM)專業考試資源中心網頁上之「招募臨時監考員 - 申請人需知」，並同意接受和遵守當中條款。 I have read the “Notice for Applicants of Ad-hoc Exam Invigilator Positions” published at the Macau Productivity & Technology Transfer Center (CPTTM) Professional Examination Resources Unit website and agree to accept and abide by the terms and conditions stated in the Notice. 網頁 Website：http://www.cpttm.org.mo/qualification 本人確認在本申請表所提供的所有資料，均屬真實正確。 I confirm that the information given in this form is true and accurate.
申請人簽名(按身份證明文件式樣) Signature by Applicant (as in Identity Card)	日期 Date

遞交申請至 For submission:

澳門生產力暨科技轉移中心 – 專業考試資源中心 新口岸上海街175號中華總商會大廈6樓 電郵: vqa@cpttm.org.mo	CPTTM Professional Examination Resources Unit Rua de Xangai, 175, Ed. ACM, 6th Fl. Email: vqa@cpttm.org.mo

Part 2 由CPTTM填寫 To be completed by CPTTM:

審核 Assessment	履歷 Resume	證書 Certificate(s)
監考員面試 (附上出席紀錄) Invigilator Interview (Attach Interview record)	合格 Pass	不合格 Fail
監考員培訓 (附上出席紀錄) Invigilator Training (Attach Attendance record)	合格 Pass	不合格 Fail
監考員評核 (附上評核紀錄) Invigilator Assessment (Attach Assessment record)	合格 Pass	不合格 Fail
附上M1表格副本 Copy of M1 form submitted
M/PD-SMTA覆核 Reviewed by M/PD-SMTA	接納 Accepted	不接納 Rejected
備註 Remarks:
簽名Signature:	日期Date
SM/SMTA覆核 Reviewed by SM/SMTA	備註 Remarks:
簽名Signature:	日期Date
PD-SMTA記錄 Recorded by PD-SMTA	符合資格者登記在臨時監考員資料庫 Qualified applicants recorded in Ad-hoc Invigilator Database
簽名Signature:	日期Date