Intern Africa | Internship application form

Application form internships

PLEASE NOTE

HOW DID YOU FIND US?

Personal information

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SURNAME

FIRST NAMES

GENDER

Male

Female

COUNTRY

NATIONALITY

TELEPHONE NUMBER

EMAIL ADDRESS *

DATE OF BIRTH

AGE

ALLERGIES/MEDICAL CONDITIONS

PASSPORT EXPIRATION DATE

EMERGENCY CONTACT DETAILS

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EMERGENCY CONTACT NAME - RELATIONSHIP TO APPLICANT

EMERGENCY CONTACT NUMBER

EMERGENCY CONTACT EMAIL ADDRESS

STUDY

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NAME OF STUDY

YEAR OF STUDY

NAME OF UNIVERSITY

CONTACT PERSON UNIVERSITY

CONTACT PERSON UNIVERSITY - TELEPHONE NUMBER

CONTACT PERSON UNIVERSITY - EMAIL ADDRESS

INTERNSHIP

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INTERNSHIP FIELD/POSITION

INTERNSHIP STARTING DATE & DURATION

OTHER INFORMATION

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DRIVING LICENSE? IF YES, PLEASE SPECIFY DATE THAT YOU OBTAINED YOUR LICENSE

WILLING TO DRIVE IN SA?

ACCOMMODATION - ANY PREFERENCES?

DID YOU FLY BEFORE?

DO YOU HAVE A CREDIT CARD?

ANY IMPORTANT INFORMATION THAT YOU WANT TO SHARE WITH US?

I AM AWARE THAT I CAN ONLY APPLY FOR AN EXCHANGE VISA IF I'M YOUNGER THEN 25.

YES

I AM AWARE THAT INTERNSHIPS ARE UNPAID AND I DO NOT EXPECT A STIPEND

YES

I AM AWARE AND AGREE TO THE ONE OF SERVICE FEE OF 420 EURO / 500 USD / 7000 ZAR (DUE UPON SIGNING INTERNSHIP CONTRACT)

YES

We are collecting your information for the purposes of processing your request. Please look at the privacy policy for more information on how we use your data. I agree to your terms and conditions and consent to my information being stored for these purposes. *

YES