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Ad hoc internship programme Picture

United Nations Regional Information Centre – Liaison Office in Bonn, Germany APPLICATION FORM PART I - TO BE COMPLETED BY THE STUDENT 1. Family Name

First Name

Middle Name

2. Sex

________________________________________________________________________________________ 3. Date of Birth (Day) (Month) (Year)

4. Place of Birth

5. Present Nationality

6. Marital Status

________________________________________________________________________________________ 7. Permanent Residential Address

9.

8. Present Address

_______________________________________

_________________________________________

_______________________________________

_________________________________________

_______________________________________

_________________________________________

_______________________________________

_________________________________________

Telephone no.: __________________________

Telephone no.: _____________________________

Office Telephone no.: ________________________

10. In case of emergency notify: Name: _____________________________________________________ Address:____________________________________________________________________________ 11. Insurance: I hereby confirm that I hold a health/accident insurance policy with the _________________ _____________________ company. My policy number is___________________________________ 12. Higher Education (College and/or University, or equivalent) Institution (Name, Place and Country) ________________________________

Years Attended

Degrees Obtained:

Major Subjects of Study

20 -20

___________

___________________

20 -20

___________

___________________

________________________________ _________________________________ _________________________________ Institution (Name, Place and Country)

Years Attended

Degrees Expected

Major Subjects of Study

_______________________________

19

-20

____________

___________________

_______________________________

20

-20

____________

___________________


-213. Employment: Please describe any previous practical experience you may have had, giving full details of your duties. _____________________________________________________________________________________ ___ _____________________________________________________________________________________ ___ _____________________________________________________________________________________ ___ _____________________________________________________________________________________ ___ N.B. If required, use additional pages. 14. Knowledge of languages: Read Easily/Not Easily

Write Easily/Not Easily

Speak Understand Easily/Not Easily Easily/Not Easily

English

_______________

_______________

_______________

________________

French

_______________

_______________

_______________

________________

Spanish

_______________

_______________

_______________

________________

Arabic

_______________

_______________

_______________

________________

Other _______________ (specify: ______________)

_______________

_______________

________________

15. Career Envisaged:_____________________________________________________________________ ____________________________________________________________________________________ 16. Other Relevant Information: a) University scholarship or academic distinctions: __________________________________________ ________________________________________________________________________________ b) To what extent are you familiar with United Nations activities: ________________________________ __________________________________________________________________________________ c)

Publications (if any):________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________

d) Have you ever applied for regular employment with the United Nations? ____________________ e) Have you ever been arrested, indicted, or summoned into court as a defendant in criminal proceeding, or convicted, fined or imprisoned for the violation of any law (excluding minor traffic violations)? Yes No If "yes", give full particulars of each case under "16 g"


-3f)

State any other relevant facts: _________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________

17. Please note that the internship programme is not connected with employment to the staff of the United Nations in any way. 18. References: List three persons, not related to you, who are familiar with your character and qualifications. Full Name Full Address Business or Occupation _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 19. I certify that the statements made by me in answer to the foregoing questions are true, complete and correct to the best of my knowledge and belief. _______________________________________________ SIGNATURE

_____________________________________ DATE

ςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςςς PART II - TO BE COMPLETED BY NOMINATING/SPONSORING INSTITUTION The following sponsoring organization: _________________________________________________________ nominates __________________________________ as a candidate to participate in the ad hoc internship programme conducted by the United Nations Regional Information Centre in Brussels under the conditions set out in the attached note. 1) duration and timing of the internship: _______________________________________________________

2) intended purpose of candidate's proposed participation in the ad hoc internship programme: _____________________________________________________________________________________ _____________________________________________________________________________________ ______________________________________________ Name of organizing university or organization (Please print)

_____________________________________ Name of certifying official (Please print)

______________________________________________

____________________________________ Signature of certifying official

______________________________________________ ______________________________________________ Address of sponsoring university or organization

_____________________________________ Date

http://www.unric.org/html/english/employment/internship_application_form  

http://www.unric.org/html/english/employment/internship_application_form.doc

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