Formularz zgłoszeniowy

This application of internship is not equivalent to start application procedures for the program and to the acceptance on the side of the internship holder.

Application for PLACEMENT
Job title:
Ref number:
First name:
Last name:
Address:
City:
Zip Code:
Country:
Tel:
Fax:
Mobile:
Email address:
Age:
Sex:	Male Female
Duration available (from you)
From (dd/mm/yy):
To (dd/mm/yy):
Year of study:
Graduation date:
Smoker?:	Yes No
University name:
University address:
Describe in less then 30 words why you are applying for this placement:
Wybierz najdogodniejszą lokalizację biura YES:	Katowice Częstochowa Gliwice Kraków Łódź Opole Poznań
Należy poprawnie wypełnić wszystkie pola formularza oznaczone symbolem