Internship-Indonesia Application Form

  Name (as appears in passport)
 

  Last name (as appears in passport)
 

  Sex Male Female
 

  Birth date (yyyy-mm-dd)
 

  Birthplace
 

  Nationality
 

  Current address
 

  E-mail
 

  Phone number
 

  Skype
 

  Current occupation
 

  Please attach your CV
 (Max. 500kb).

  Please attach first picture
 (Max. 250kb).

  Please attach second picture
 (Max. 250kb).

  How do you know about
  Internship-Indonesia?
 

  Why would you like to go to Indonesia?
 

  Earliest starting date (yyyy-mm-dd)
 

  Preferred duration of internship
  (4-24 weeks)
 

I hereby give consent for my personal data included in this form to be processed for the purposes of registration to Internship-Indonesia programe, in accordance with the Personal Data Protection Act dated 29.08.1997 (uniform text: Journal of Laws of the Republic of Poland)
 

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