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: ______/_______/__________
Place of Birth: ____________________________________________________________________________
____________________________________________________________________________
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
Town/City
Country
Date Month Year
3. EDUCATION
Type of School Name and Location Date Level
4. 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 1 2 3 4 5 • Social Media 1 2 3 4 5
Writing Skills
• Meetings 1 2 3 4 5 • Formal Letters 1 2 3 4 5 • Reports 1 2 3 4 5 • Articles 1 2 3 4 5
Facilitation Skills
• Workshops 1 2 3 4 5 • Meetings 1 2 3 4 5
Self Management 1 2 3 4 5
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. IMPORTANT DATES
Deadline for Application:
Pre-Departure Training/Briefing in Trinidad: 23rd – 28th February 2012
Internship placement: 1st March – 30th June 2012
9. 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 designed to provide Regional youth sport leaders an opportunity to strengthen and enhance their capacity in managing sport for development activities including aspects of organizational and program management.
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 February - June 2012 for the duration of a 3-5 month placement. All applicants MUST be prepared to live in the selected countries for the specific round of internship placements. Successful interns would be required to operate under the TTASPE Caribbean Internship Guidelines.
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 – [email protected]
Mail – 312 Soogrim Street Gulf View La Romaine Trinidad & Tobago
For further information visit our website at www.ttaspe.org