* Full name:
(as it appears in your passport)
* I am applying to go to:
Please select...
Czech Republic
France
Germany
Ireland
Italy
Malta
Portugal
Spain
* My preferred destination and start date
is:
Select a country to continue.
* I would prefer my internship in:
Select a destination to continue.
* I would like to attend my interview on:
1st choice date
20 May 2008
21 May 2008
10 Jun 2008
11 Jun 2008
12 Jun 2008
08 Jul 2008
09 Jul 2008
05 Aug 2008
06 Aug 2008
2nd choice date
20 May 2008
21 May 2008
10 Jun 2008
11 Jun 2008
12 Jun 2008
08 Jul 2008
09 Jul 2008
05 Aug 2008
06 Aug 2008
3rd choice date
20 May 2008
21 May 2008
10 Jun 2008
11 Jun 2008
12 Jun 2008
08 Jul 2008
09 Jul 2008
05 Aug 2008
06 Aug 2008
* I would prefer my interview time to be:
In the morning In the afternoon
* If offered a place, I will attend the social event:
(see handbook for dates)
Yes No
PERSONAL DETAILS
* Email address:
(please ensure you enter an address that can be used throughout the
programme)
(e.g. johnsmith@example.com)
* Gender:
Male Female
* Date of birth
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
/
MMM
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
/
YYYY
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
* Nationality:
Please select...
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas, The
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burma
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo (Brazzaville)
Congo (Kinshasa)
Costa Rica
Cote d' Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
DOM/TOM
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
England
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia, The
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haitii
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Ireland (Northern)
Israel
Italy
Jamaica
Japan
Jordan
Kanka
Kazakhstan
Kenya
Kiribati
Korea, North
Korea, South
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Moldova
Monaco
Mongolia
Morocco
Mozambique
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Scotland
Senegal
Serbia
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
St. Kitts and Nevis
St. Lucia
St. Vincent/Grenadines
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Wales
Yemen
Zambia
Zimbabwe
* Please describe your ethnic background:
Please select...
White - British
White - Irish
White - Other
Mixed - White & Black Caribbean
Mixed - White & Black African
Mixed - White & Asian
Mixed - Other
Asian or Asian British - Indian
Asian or Asian British - Pakistani
Asian or Asian British - Bangladeshi
Asian or Asian British - Other
Black or Black British - Caribbean
Black or Black British - African
Black or Black British - Other
Chinese
Other
Not Known
* Passport number:
* Address 1:
Address 2:
* City / town:
County/province/state:
* Postcode:
* Country of residence:
Please select...
Afghanistan
Albania
Algeria
Andorra
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Bashkir
Basque
Belarus
Belgium
Bolivia
Bosnia
Botswana
Brazil
Bulgaria
Burkina Faso
Burma
Cameroon
Canada
Chad
Chile
China
Colombia
Congo
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Estonia
Finland
France
Gabon
Georgia
Germany
Ghana
Greece
Guatemala
Guinea
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Ivory Coast
Japan
Jordan
Kazakhstan
Kenya
Kirgizistan
Korea
Kosova
Kuwait
Kyrghyzstan
Latvia
Lebanon
Libya
Lithuania
Macedonia
Malaysia
Mali
Malta
Mexico
Moldova
Mongolia
Morocco
Myanmar
Nepal
Netherlands
Nigeria
North Cyprus
Norway
Oman
Pakistan
Palestine
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Saudi Arabia
Serbia
Serbia & Montenegro
Sierra Leone
Slovakia
Slovenia
South Africa
South Korea
Spain
Sri Lanka
Sudavies
Sweden
Switzerland
Syria
Taiwan
Tanzania
Thailand
Tunisia
Turkey
Turkmenistan
Uganda
UK
Ukraine
United Arab Emirates
Uruguay
USA
Uzbekistan
Venezuela
Vietnam
Yemen
* Telephone:
Mobile:
* Current status:
(please describe what you are currently doing, ie, employed, student,
job seeker etc.)
* Do you have any beliefs, religious or otherwise,
that prevent you from working at certain times:
Yes No
If Yes, please provide details:
EMERGENCY DETAILS
* First name
* Last name:
* Relationship to the participant:
Please select...
Father
Mother
Brother
Sister
Other
Email address:
(e.g. johnsmith@example.com)
* Telephone:
Mobile:
HEALTH
* Do you regularly take any prescription drugs:
Yes No
* Do you suffer from allergies, asthma, epilepsy
or diabetes:
Yes No
* In the last 3 years have you undergone any
major surgery:
Yes No
If Yes, please provide details:
* In the last 3 years have you suffered any
psychiatric / psychological illnesses:
Yes No
If Yes, please provide details:
* Please describe your fitness level:
Super fit – marathon runner Generally Fit – exercise regularly Average fitness – periodically exercise Unfit – no structured exercise Couch potato!
* Are you a smoker:
Yes No
* Are you registered disabled:
Yes No
If Yes, please describe:
* Do you have any mobility restrictions that
might influence your internship:
Yes No
If Yes, please describe:
TRAVEL EXPERIENCE
* Have you lived or worked abroad before:
Yes No
If Yes, please describe where and what you were doing:
DATES
* Are you able to commit to the full duration
of the programme:
Yes No
* Are there any dates that you might have
to leave the programme for:
Yes No
If Yes, what are the dates and why do you need to return:
EXPECTATIONS
* Why have you chosen to apply for Leonardo
da Vinci:
* What do you hope to gain from the programme:
* How do you feel this will benefit your career
aspirations:
* Describe your ideal internship:
* Give examples of the type of position you
would like:
ADDITIONAL INFORMATION
* Please upload your completed Europass CV
here:
(DOC, TXT, PDF, JPEG, and HTML filetypes are supported)
* Please upload your completed Motivation
Letter here:
(DOC, TXT, PDF, JPEG, and HTML filetypes are supported)
* Please upload your passport photo here:
(JPEG, GIF, TIFF, PNG, and BMP filetypes are supported)
* I give permission for my email address to
be shared with other COMPASS participants:
Yes No
* How did you hear about Twin:
Please select...
Search engine
Climate Care
Gapyear.com
Gapwork.com
Objective Gap Safety
Responsible Tourism
Email newsletter
University Representative
Taking a Gap Year
Brochure/flyer/poster
Magazine advert
Fair/exhibition
Word of mouth
Other
I confirm that I have read and understand the Leonardo da Vinci COMPASS 2008 Handbook :
* Mandatory fields