Page 1

INTERN EXCHANGE APPLICATION FORM To be completed by the applicant 1.

PERSONAL INFORMATION Surname Name: __________________________________________________________________________ First Name: _______________________________________________________________________________ Sex:

MALE

FEMALE

Marital Status: ___________________________

Date of Birth: ______/_______/__________ Date

Month

Year

Place of Birth: ____________________________________________________________________________ Town/City

____________________________________________________________________________ Country

Present Nationality: _________________________________________ Permanent Home Address: _____________________________________________________________ _____________________________________________________________________________________________

Present Address: _________________________________________________________________________ _____________________________________________________________________________________________

2.

CONTACT INFORMATION Home: __________________________________

Mobile: ___________________________________

Email: _________________________________________________ Insurance: I hereby confirm that I hold a health/accident insurance policy with _____________________________________________________________________________________________ (Attach a copy) Expiry date of policy: ________/________/___________ Date

Month

Year


3.

EDUCATION

Type of School

4.

Name and Location

Date

Level

COMPETENCIES On a scale of 1 to 5 rate yourself as to what you believe your level of ability to be against each competency. (1 being the highest and 5 the lowest) Computer Literacy  

Microsoft Office Suite Social Media

1 1

2 2

3 3

4 4

5 5

1 1 1 1

2 2 2 2

3 3 3 3

4 4 4 4

5 5 5 5

Workshops Meetings

1 1

2 2

3 3

4 4

5 5

Self Management

1

2

3

4

5

Writing Skills    

Meetings Formal Letters Reports Articles

Facilitation Skills  

Relevant volunteer activities:

Awards/honours/scholarships received:


5.

EMPLOYMENT Using the format below, please describe any previous practical experience you may have had, giving full details of your duties starting from your most recent engagement. (Include paid and intern positions) Employer: ________________________________________________________________________________ Address: __________________________________________________________________________________ Contact: ___________________________________________________________________________________ Supervisor (Name and Title):___________________________________________________________ Position Title:________________________________ Start Date______/______/_______

End Date______/______/______

Description of Duties: ___________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________

Employer: ________________________________________________________________________________ Address: __________________________________________________________________________________ Contact: ___________________________________________________________________________________ Supervisor (Name and Title):___________________________________________________________ Position Title:________________________________ Start Date______/______/_______

End Date______/______/______

Description of Duties: ___________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________


Employer: ________________________________________________________________________________ Address: __________________________________________________________________________________ Contact: ___________________________________________________________________________________ Supervisor (Name and Title):___________________________________________________________ Position Title:________________________________ Start Date______/______/_______

End Date______/______/______

Description of Duties: ___________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ 6.

REFERENCES Name: _____________________________________________________________________________________ Company/Institution/Organization: ___________________________________________________ Contact: ___________________________________________________________________________________ Relationship: ___________________________________

Name:_____________________________________________________________________________________ Company/Institution/Organization: ___________________________________________________ Contact: ___________________________________________________________________________________ Relationship: ___________________________________


7.

WHAT ARE YOUR CAREER PLANS FOR THE FUTURE?


8.

APPLICATION CHECKLIST I have answered all the questions I am available to complete an internship of 12 weeks on a full time basis I have a valid passport I have attached copies of the following: o Cover Letter (letter of intent) o 2 Written references/recommendations o Copy of Insurance cover o Copy of data page of passport

I certify that all of the statements in this application are true and complete to the best of my knowledge.

Signature: ___________________________________

Date of Birth: ______/_______/_________ Date

Month

Year


Internship Program Information

This internship/exchange program is for the Game On! Program. Game On! Programs are designed to give children the ability to develop PE and Sport Skills while learning how to make healthy lifestyle choices and develop positive social behaviours. Using Game On! children use sport to develop personal and social responsibility using structured plans that are designed to complement PE curriculums and sport training plans through certified teachers, coaches and volunteers. Eligibility: General Information: Interns are expected to work between 20 to 40 hours per week during a 12 week period. Internships are offered during the period of October - February 2013 for the duration of a 3-5 month placement. All applicants MUST be prepared to travel in selected countries. Attached is a copy of the Job Description for this program. Application Procedures: Candidates must complete an application form and submit it with their cover letter, resume and references. All applications must be submitted as a complete package. Incomplete applications will not be reviewed.

Mail or Email Applications with subject “Internship Program” to: Email – ttaspe@ttaspe.org Mail – 312 Soogrim Street Gulf View La Romaine Trinidad & Tobago For further information visit our website at www.ttaspe.org


Internship Form-Game On  

This internship/exchange program is in support of the Game On! Program. Game On! Programs are designed to give children the ability to devel...

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