Scribd
Upload
53 views3 pages

AEC Semarang Program Application Form

This document is an application form for an overseas program. It requests personal details like name, date of birth, citizenship, and passport information. It also asks for contact details, an emergency contact, details about the applicant's institution or occupation, language abilities, and questions about personality, strengths/weaknesses, and past overseas experience. The final section lists agreements the applicant must consent to regarding responsibility for expenses, valid travel documents, insurance, understanding risks of force majeure events, standards of conduct, and use of photos/testimonials. The applicant must provide a signature and date to accept placement under the conditions.

Uploaded by

eni
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
53 views3 pages

AEC Semarang Program Application Form

This document is an application form for an overseas program. It requests personal details like name, date of birth, citizenship, and passport information. It also asks for contact details, an emergency contact, details about the applicant's institution or occupation, language abilities, and questions about personality, strengths/weaknesses, and past overseas experience. The final section lists agreements the applicant must consent to regarding responsibility for expenses, valid travel documents, insurance, understanding risks of force majeure events, standards of conduct, and use of photos/testimonials. The applicant must provide a signature and date to accept placement under the conditions.

Uploaded by

eni
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

APPLICATION FORM

1. PERSONAL DETAIL
DATE OF BIRTH TIT MR MISS MS
LE: MRS
GIVEN NAME [AS STATED
IN PASSPORT]
FAMILY NAME [AS
STATED IN PASSPORT]
COUNTRY OF COUNTRY
CITIZENSHIP OF BIRTH
PASSPORT NUMBER
ISSUING DATE
EXPIRING DATE

2. CONTACT DETAIL
FULL
ADDRESS
SUBURB / STATE/PROVINCE
TOWN
COUNTRY TELEPHONE
HANDPHONE EMAIL 1
POSTCODE EMAIL 2

3. EMERGENCY CONTACT
FULL NAME
TELEPHONE YOUR RELATIONSHIP
WITH HIM/HER
EMAIL

4. INSTITUTION OR UNIVERSITY
OCCUPATION STUDENTS WORKING OTHERS
NAME OF UNIV. MAJOR / POSITION
OR OFFICE
WEBPAGE TELEPHONE

5. LANGUANGE ABILITY
MOTHER TOUNGE
ENGLISH VERY GOOD GOOD FAIR
OTHERS
[SPECIFY]
6. Q1: TELL US ABOUT YOUR PERSONALITY: 150 – 200 WORDS

7. Q2: TELL US ABOUT YOUR STREGHT AND WEKNESS: 150 – 200


WORDS

8. Q3: DO YOU HAVE AN OVERSEAS PROGRAM EXPERIENCE?


PROGRAM, COUNTRY, ORGANIZER, YOUR ROLE?

9. AGREEMENTS
9.1. I agree to pay all the expenses associated with this program,
including but not limited to:
~ Coordination fee, flight/travel, visa
~ Any cost resulting from the modification or termination of my
program
9.2. I understand that it is my responsibility to obtain a passport prior
to my departure, or ensure my current passport is valid for the
duration of the program and an additional six months or as stated in
host country policy.
9.3. I understand that it is my responsibility to obtain the appropriate
visa/s for the duration of the program from the relevant consulate,
prior to my departure.
9.4. I understand that it is my responsibility to obtain sufficient
medical and travel insurance to cover me for the duration of my
program. This includes travel to and from my destination and travel to
and from my program.
9.5. I understand that due to the international nature of the program
and FORCE MAJEURE, unforeseen events may occur such as the
outbreak of war, civil unrest or natural disaster that may be a risk to
my safety. I agree that AEC Semarang may modify or terminate my
participation in the pprogram in such circumstances.
9.6. I acknowledge that it is my responsibility to arrange my own
insurance NOT AEC Semarang
9.7. I agree that AEC Semarang may terminate my participation in
the program prior to or during the program if I fail to maintain, what
AEC Semarang considers, an acceptable standard of conduct.
9.8. I consent that any photographs or testimonials I provide to AEC
Semarang (during the program) can be used in AEC Semarang
promotional materials.

Paste Your
Passport size
Photograph
Here

I, (full name) agree to accept a placement in AEC Semarang program on the


above cconditions.

DATE: ________________________

You might also like