Caux Interns Application form

Applications close 15 January 2013

Firstname: *

Lastname: *

Date of Birth: *

Gender: *

Male

Female

Email: *

Street: *

Town: *

Postcode: *

Country: *

Nationality (as shown on passport): *

Skype ID:

Telephone: *

Language: *

Please enter all languages you speak. Each in a seperate line (mother tongue first).

English standard (spoken): *

English standard (written): *

Current occupation: *

Caux visits: *

Yes

Have you visited Caux before?

If yes, which year?:

Availability

The 2013 Caux Interns Programme will be divided into two periods. Please indicate whether your preference is for Session 1 or 2.

Preferred Session: *

Session 1: 22 June (evening) – 20 July (inclusive)

Session 2: 15 July (evening) – 12 August (inclusive)

Session 1 and 2:

Yes

There may be a limited number of positions available for the whole summer. Please indicate if you would like to be considered for one of these (as well as marking your preference above).

Areas of Interest

Please indicate your first three preferences, numbered 1-3

Interest one: *

Interest two: *

Interest three: *

Additional Information

Resume upload: *

Please upload a 1-2 page resume, preferably in pdf format.

Leadership experience: *

What experience do you have in leadership and/or management? (150 words)

Cultural experience: *

Do you have experience of working with mixed language and culture groups? If so, please give a brief description of the most significant one. (150 words)

Skills: *

What skills do you have relevant to the area(s) of service you have chosen? (150 words)

Qualities: *

What qualities do you feel you would bring to the tasks? (150 words)

Expectations: *

Please describe why you would like to have this experience at Caux. (200 words)

References

Please provide name and contact details of two referees (including e-mail and contact number)

Person 1: *

Person 2: *

Do you have any current or long term health problems which may affect your ability to work?

Select: *

Yes

If yes, please give brief details:

NOTE: *

I have read and understand that all interns will be required to provide their own health and travel insurance, and undertake to do so if selected.

Acceptance of terms: *

I confirm that I have read and fully accept the terms of the Interns Agreement.

You will find the Intern Agreement here!

Registration fee: *

I understand that, if selected, I will be required to pay a non-refundable registration fee of 100 CHF, and a Conference Centre fee of 50 CHF, to be paid with the registration fee or on arrival in Caux. (Consideration will be given to requests for a waiver of the registration fee, in cases of financial difficulty.)

Use of data: *

I authorise the 2013 Caux Interns Programme to store my application data in electronic form for the purpose of managing my application and communicating with me (including after the Programme, if I am accepted). Please tick the box to confirm your authorisation.

After submitting you will be redirected to a confirmation page. Also you will receive an Email with your application date to the given Email-Address. If you do not see the confirmation page and do not receive the Email, please inform us at interns@caux.ch.

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Caux Interns Application form

CONFERENCE REGISTRATION