Management Of International Placement
Personal Details
First Name
Last Name
Other Names
Nationality
Passport Number
Date Of Birth
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January
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December
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1901
1900
Gender
Male
Female
Contact Details
Address (Line 1)
Line 2
Line 3
Line 4
Post Code
Tel
Mobile
Email
Emergency Contact Details
First Name
Last Name
Tel
Mobile
Email
Medical History
Please give details of any medical conditions
Placement
Preferred Placement Sector
Administation
Construction
Engineering
Finance
Health Care
Hospitality
Human Resources
IT
Marketing
Other
If Other Please Specify
Will you be required to complete any assignments during your placement
Yes
No
If Yes Please Specify
Preferred Placement Duration
1-2 Weeks
2-4 Weeks
1-2 Months
2-3 Months
3-4 Months
4 Months +
Preferred Start Date
01
02
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Day
January
February
March
April
May
June
July
August
September
October
November
December
Month
2007
2008
2009
2010
2011
Dates Unavailable for Placement If Any
Education
Are You A Current College/University Student
Yes
No
Graduation Date
01
02
03
04
05
06
07
08
09
10
11
12
13
14
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Day
January
February
March
April
May
June
July
August
September
October
November
December
Month
2007
2008
2009
2010
2011
College/University Name
Degree Title
Details Of Other Qualifications
Stating Qualification Title, Institute Name & Dates Obtained
Work Experience
Please detail any previous work experience. State company name & address, date of placement and a brief job description
Skills
Please list below any skills you have. i.e using Microsoft Word & Excel
Interests
Please list your hobbies & interests
Career Aspirations
Please give details
Overseas Experience
Have You Ever Travelled Overseas
Yes
No
Countries Visited
If your visit was for study or work placement, please give details. Include university or business name & address & dates
Where Did You Hear About MIP
University Tutor
From A Friend
Website
Media
