resumo

Title

Family Name

First Name(s)

Maiden Name (if applicable)

Marital Status

Gender

Date of birth

Nationality

Second Nationality (if applicable)

Country of Birth

Place of Birth

Home Address

Home Address (line 1 - max 32 chars)

Home Address (line 2 - max 32 chars)

City

Country

Postal Code

E-Mail Address

Telephone Number (home)

Telephone Number (mobile)

Telephone Number (office)

Fax Number

Correspondence Address (if different from above)

Address for Correspondence (line 1 - max 32 chars)

Address for Correspondence (line 2 - max 32 chars)

City

Country

Postal Code

Correspondence Address Valid Until (dd/mm/yyyy)

Have you previously applied for a position at CERN? If yes, please give details (date, position etc.)

Are you working, or have you worked at CERN before? If yes, please give details (dates, position etc)

Are you working for or have you worked for a firm on the CERN site? If yes, please give the name of the firm.

Please give your date of leaving, if you have worked at CERN previously

Please give your CERN ID number (if applicable)

How did you learn about job or training opportunities at CERN?

Main field of Interest/Study*

If Other, please specify

Miscellaneous Information

Please give details of the work you are interested in doing at CERN*

What is the motivation for your application?

What is the motivation for your application? Note: Applicants for Fellowships and Student Programmes are particularly encouraged to complete this section explaining what they hope to achieve at CERN and their interest in this programme.

Remarks - Please add any other relevant information in support of your application. This may include reference number from advertisement, information about visits abroad or military or civil service, for example.

Attended From

Attended To

School/University Name

Country

Education Level

Title of Diploma/Qualification

Note: Please give the full title in their original language.

The qualification is...

Grades/Dates Obtained/Expected

Attended From

Attended To

School/University Name

Country

Education Level

Title of Diploma/Qualification

Note: Please give the full title in their original language.

The qualification is...

Grades/Dates Obtained/Expected

Mother Tongue

If Other, please specify

Other Languages

1st Language

Reading

Writing

Speaking

2nd language

Reading

Writing

Speaking

3rd Language

Reading

Writing

Speaking

Word Processing

Please give details

Other Software Packages

Please give details

Computer Languages

Please give details

Computer Hardware

Please give details

Operating Systems

Please give details

Joining and Leaving Dates - From

Date to

Name of your Employer

Address of your Employer

Title of your Supervisor

Name of your Supervisor (if applicable)

Title of your Position

Job Description

Notice Period (if applicable)

Reasons for your wish to leave (if applicable)

Annual Net Starting Salary

Annual Net Final Salary

Joining and Leaving Dates - From

Date to

Name of your Employer

Address of your Employer

Title of your Supervisor

Name of your Supervisor (if applicable)

Title of your Position

Job Description

Notice Period (if applicable)

Reasons for your wish to leave (if applicable)

Annual Net Starting Salary

Annual Net Final Salary

Joining and Leaving Dates - From

Date to

Name of your Employer

Address of your Employer

Title of your Supervisor

Name of your Supervisor (if applicable)

Title of your Position

Job Description

Notice Period (if applicable)

Reasons for your wish to leave (if applicable)

Annual Net Starting Salary

Annual Net Final Salary

If selected at what date would you be able to start your appointment (mm/yyyy)?

Project/Thesis Details

First Referee

Full Name

Profession

Address

Telephone Number

E-mail Address

Second Referee

Full Name

Profession

Address

Telephone Number

E-mail Address

Can you obtain detachment/secondment from your present employer?

Membership of professional societies

Names of relatives working at CERN and their relationship to you