STUDENT NOMINATION Ref. No. Mã offer
Family name: Date of birth:
Middle Name Place of birth:
First name: Gender:
Passport no.: nếu chưa làm HC thì ghi In process
Place of issue: ghi là Vietnam
Valid until: nếu chưa làm HC thì ghi In process
Phone no: + 84
Alternative phone no: + 84 Email:
Field of study: Specialization:
Languages: ghi ngoại ngữ + Level; VD: English (good); German (good); French (fair), etv
Completed years of study: Total years required:
Working related information
Desired period of training: from ngày, tháng, năm to ngày, tháng, năm
Thời gian e đăng kí thực tập cần đảm bảo số tuần tối thiểu, tối đa; trong khoảng thời gian Work Offer yêu c
Do you wish lodging to be found for you? Yes No
Do you wish to prepare an internship report during the training period? Yes No
- I agree that the personal data, which has been provided to IAESTE, may be passed to IAESTE member countries (full members, associate members and cooperating institutions) and potential employers for the purpose of arranging my traineeship. Also my personal data may be provided to government authorities for the issuance of visa/work permit purpose.
- I am aware that I am not allowed to contact the company or the Receiving Country before being accepted. You are accepted for this training offer only after receipt of the IAESTE acceptance form.
- I confirm that all the data I provide is correct.
Date: Student’s signature: điền họ tên hoặc chèn chữ kí điện tử
For internal use
Nominating country: On behalf of sending country
Assoc. Prof. Hoang Van Phu, Person in Charge
International Association for the Exchange of Students for Technical Experience - IAESTE a.s.b.l.
51, rue Albert 1er, L-1117 Luxembourg / R.C.S. Luxembourg F1180