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INTERNSHIP
PROGRAMME
(GENEVA)
APPLICATION FORM
PART I -
TO BE FILLED OUT BY THE APPLICANT
1. Surname
__________________________
. |
Name
__________________________
. |
2. Sex
__________________________
. |
3. Civil
status
__________________________
. |
4. Date of
birth
(day)
(month) (year)
__________________________
. |
5. Place of birth
.
__________________________
. |
6a.
Nationality
__________________________
. |
6b. Valid Work Permit
(B,C, F, N, or Other)
__________________________
. |
7. Permanent address
__________________________
__________________________
__________________________
__________________________
tel________________________
.
|
8. Current address
_________________
__________________________
__________________________
__________________________
tel________________________
. |
|
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9. Person to
be warned in case of emergency: Name ___________________________
Address:
_____________________________________________________________
10.
Insurance: I confirm that I have health/accident insurance with the
following company:
__________________________________________________________
The insurance
policy number is:
__________________________________________________________.
11. Knowledge
of languages: What is your mother tongue? __________________
| . |
Do you
read easily/with difficulty |
Do you
write easily/with difficulty |
Do you
speak easily/with difficulty |
Do you
understand easily/with difficulty |
| English |
. |
. |
. |
. |
| French |
. |
. |
. |
. |
| Spanish |
. |
. |
. |
. |
Other
languages
(please specify) |
. |
. |
. |
. |
12. Advanced
studies (University or equivalent):
|
|
|
Academic
institution
(name, city and country) |
Years |
Degree(s)
obtained |
Principal
areas of study |
| . |
19__-19__ |
. |
. |
| . |
19__-19__ |
. |
. |
| . |
19__-19__ |
. |
. |
| . |
19__-19__ |
. |
. |
| . |
19__-19__ |
. |
. | |
Degree you
expect to obtain
____________________________________________________________________
____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
13.
Employment: Describe your responsibilities if you have had professional
experience
(use additional pages, if necessary).
_____________________________________________________________________
____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
14. Envisaged
career:
___________________________________________________
_____________________________________________________________________
_____________________________________________________________________
15. Other
useful information:
a)
Academic scholarship or distinctions:
______________________________________
________________________________________________________________________
________________________________________________________________________
b) List
of any significant work you have published:
_______________________________________________________________________
_______________________________________________________________________
c) Have
you previously submitted an application for internship or employment with
the United Nations? ___________________________________________________
d) Have
you ever been arrested, indicted or summoned into court as a defendant in
a criminal proceeding, or convicted, fined or imprisoned for the violation
of any law (excluding minor traffic violation)?
YES
_________
NO ___________
If "yes",
give full particulars of each case in attached statement.
16. Proposed
dates for internship: From _________________ to
_________________
17. What is
your preferred field of work?
To facilitate your placement, please
list the principal fields of activity of the Office of the High
Commissioner for Human Rights of interest to you, in order of preference.
________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
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 |
SECTION II
- TO BE FILLED BY THE INSTITUTION OR ORGANISATION WHICH
PROPOSES/SUPPORTS THE CANDIDATE
Name of the
institution/ organisation: ______________________________________________
proposes/supports the candidate to participate to the United Nations
internship programme in Geneva.
1) Term
and dates of the internship: _________________________________________
2) Aims
of the Candidate's participation in the internship programme:
_______________________________________________________________________
_______________________________________________________________________
Name and
address of the institution/organisation which proposes/supports the
candidate
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Name et title
of the authorized to sign:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
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