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                                                          Intern Application Form

 

 

 

 

ICPO-INTERPOL

Personal details

Family name: Lindblom

     

Maiden name (if applicable):

     

Forename(s): Eric

     

Date of birth:

      (dd/mm/yyyy)

Place of birth:

Town :  

     

Country:

     

Current nationality:

     

Acquired by:      

Other nationality(-ies):

     

Mailing address   

No. & Street: Grant

              

Zip/Post code: 94133

              

Town: San Francisco

     

Country: USA

     

Telephone:

     

Mobile:

     

Fax:

     

E-mail:

     

Preferred internship assignment

To facilitate placement, please indicate in order of priority the preferred areas of activity within I.C.P.O. for which you wish to be considered for internship based on your educational background and interests (See Acronyms notice).

1)    Peru  

2)      

3)      

Indicate the reasons of your choice

 

Dates proposed for the Internship

From: (month/year) 8/2007

To: (month/year)

Compulsory internship :        Yes/No

Education

Give full details in reverse chronological order (starting from the latest).

Give the exact name of the institution and title of degree in the original language.

Do not include primary/secondary school if you have a university degree or equivalent.

Years

Institution

(name, place)

Degree obtained

Main field(s) of study

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

Language skills

Mother tongue:

     

For languages other than mother tongue, enter appropriate letter from coding below to indicate the level of your knowledge.

A- Professional Fluency: Able to converse actively at high level of fluency and prepare reports and papers

B- Working Knowledge: Able to follow work-related discussions, use the telephone, and understand documents-grammar may be uncertain.

C- Limited Knowledge: Able to understand simple conversations and written texts.

Language

Understand

Speak

Read

Write