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Internship Application Form

INSTRUCTIONS
Please answer each question clearly and completely. Read carefully and follow all directions. Do not attach CV. Only the information
provided in this form will be considered. TYPE OR PRINT IN INK.

1. TOPIC APPLIED FOR (pleae indicate the relevant reference number):

PERSONAL DATA
2. 3. 4.

Family Name First & Middle Name Maiden Name, if any

5. 6. 7. 8.
Date of Birth (dd/mm/yyyy) Place of Birth Marital Status Gender
9. 10. 11.
Nationality at Birth Present Nationality Second Nationality, if any

CONTACT INFORMATION

12 13.
.
Permanent Address (Street, City, Country) Current Home Telephone No.
14 15.
.
Present Address (Street, City, Country) Work Telephone No.
16 17.
.
E-Mail Address Mobile Telephone No.

18. EDUCATION - Give exact names of institutions and titles of degrees above secondary school, as they appear in the diploma(s). Please do not
translate or equate to other degrees. Please attach copies of the degrees, transcriptions and academic distinctions, officially translated into
English, as quoated below.
Month/Year attended
Degrees and Academic Distinctions Main Course of Study Name, Place and Country
from to

Please indicate if any of the studies specified above was not finished or is in progress and give reasons for any overlaps of study periods. If you wish,
provide any other information regarding your education that you consider relevant:
19. EMPLOYMENT RECORD - Starting with your most recent post, list in reverse order every appointment you have had. Use a separate block for
each post. Include also service in the armed forces and note any period during which you were not gainfully employed. If you need more space,
attach additional pages of the same size.

Total
From (mm/yyyy) To (mm/yyyy) Exact title of your post:
Year(s) Month(s)
Type of business:
Name, address and phone number of employer:

Name, title and email address of supervisor:

Have you any objections to our making enquiries of your employer?
Number and kind of employees supervised by you: Reason for leaving:
Total annual net income (after deduction of tax):
DESCRIPTION OF YOUR DUTIES:

Total
From (mm/yyyy) To (mm/yyyy) Exact title of your post:
Year(s) Month(s)
Type of business:
Name, address and phone number of employer:

Name, title and email address of supervisor:

Have you any objections to our making enquiries of your employer?
Number and kind of employees supervised by you: Reason for leaving:
Total annual net income (after deduction of tax):
DESCRIPTION OF YOUR DUTIES:

Total
From (mm/yyyy) To (mm/yyyy) Exact title of your post:
Year(s) Month(s)
Type of business:
Name, address and phone number of employer:

Name, title and email address of supervisor:

Have you any objections to our making enquiries of your employer?
Number and kind of employees supervised by you: Reason for leaving:
Total annual net income (after deduction of tax):
DESCRIPTION OF YOUR DUTIES:
 Total
From (mm/yyyy) To (mm/yyyy) Exact title of your post:
Year(s) Month(s)
Type of business:
Name, address and phone number of employer:

Name, title and email address of supervisor:

Have you any objections to our making enquiries of your employer?
Number and kind of employees supervised by you: Reason for leaving:
Total annual net income (after deduction of tax):
DESCRIPTION OF YOUR DUTIES:

Total
From (mm/yyyy) To (mm/yyyy) Exact title of your post:
Year(s) Month(s)
Type of business:
Name, address and phone number of employer:

Name, title and email address of supervisor:

Have you any objections to our making enquiries of your employer?
Number and kind of employees supervised by you: Reason for leaving:
Total annual net income (after deduction of tax):
DESCRIPTION OF YOUR DUTIES:

Total
From (mm/yyyy) To (mm/yyyy) Exact title of your post:
Year(s) Month(s)
Type of business:
Name, address and phone number of employer:

Name, title and email address of supervisor:

Have you any objections to our making enquiries of your employer?
Number and kind of employees supervised by you: Reason for leaving:
Total annual net income (after deduction of tax):
DESCRIPTION OF YOUR DUTIES:
 Total
From (mm/yyyy) To (mm/yyyy) Exact title of your post:
Year(s) Month(s)
Type of business:
Name, address and phone number of employer:

Name, title and email address of supervisor:

Have you any objections to our making enquiries of your employer?
Number and kind of employees supervised by you: Reason for leaving:
Total annual net income (after deduction of tax):
DESCRIPTION OF YOUR DUTIES:

20. If you have had more jobs, please describe them below. Please indicate the total number of years and months of each employment.

21. DEPENDENTS - If you have dependents give the following information:

Date of Birth
Name Relationship Age Status (studying, working, etc.)
(Year/Month/Day)

If you wish, provide any other information regarding your dependants that you consider relevant:

22. KNOWLEDGE OF LANGUAGES:

What is your mother tongue?

Please specify other languages you know and indicate your level of knowledge by using the following keys: LIMITED (LIM) = Limited conversation,
reading of newspapers, routine correspondence. WORKING KNOWLEDGE (WK) = Engage freely in discussions, read and write more complex material.
FLUENT (FL) = Speak, read and write nearly as well as mother tongue.

No. Language Speak Read Write

1.
2.
3.
4.
5.
6.
7.
8.
23. PUBLICATIONS (for professional or scientific posts only)
List any significant publications you have written.

24. OFFICE SKILLS (For clerical posts only) - Indicate speed in words per minute. Add other languages if necessary.
English
Typing

List special clerical/secretarial skills you possess and any office machine or equipment you can use:

25. COMPUTER SKILLS

Please indicate and comment on your computer knowledge in the areas listed below. When indicating your level of knowledge, use the following keys:
FAIR = limited experience. WORKING KNOWLEDGE = regular use of the software and ability to apply it to meet the requirements of the job. PROFICIENT
= advanced user; able to perform complex tasks. If you have no knowledge of any area, leave the corresponding field blank.

Word Processing:

Spreadsheets:

Presentation/Desktop publishing:

Databases:

Internet:

E-Mail/Communication:

Programming:

Other software:

Computer hardware/Special equipment:

26. List membership in professional societies and activities in civic, public or international affairs.
27
.
MISCELLANEOUS
Have you taken up legal permanent residence status in any country other than that of your
nationality?
Have you taken any legal steps towards changing your present nationality?
If the answer to either question is yes, explain fully:

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 violations)?

If yes, give full particulars of each case in an attached statement.

State any other relevant facts. Include information regarding any residence outside the country of your nationality.

Where did you learn about job opportunities at OPEC?

28
.
WORK CONDITIONS
Have you previously worked for OPEC?
If so, when?
Have you previously submitted an application for employment with OPEC?
If so, when?

29. Do you know anyone in OPEC?

If the answer is yes, give the following information:
Name Position Relationship

30. REFERENCES - List three persons, not related to you, who are familiar with your character and qualifications. DO NOT repeat names of
supervisors listed in the employment record.
Full name Full address, phone number and e-mail address Business or occupation

31. IMPORTANT - Please provide any other information that you consider important for the evaluation of your candidature:

32. Would you require any special/specific support to attend an interview in the premises of the OPEC Secretariat?

33. I certify that the statement made by me in answer to the foregoing questions is true, complete and correct to the best of my knowledge and belief.
Furthermore, I consent to my data being collected, stored, and processed in line with the OPEC Data Protection Policy.

Date: Signature: