| APPLICATION DATE |
|
| NAME, FAMILY NAME |
|
| DATE OF BIRTH-PLACE OF BIRTH |
|
| GENDER |
Female
Male
|
| FATHERS NAME, OCCUPITATION |
|
| MOTHERS NAME, OCCUPITATION |
|
| NATIONALITY |
|
| NAME OF THE PRIMARY SCHOOL-TOWN |
|
| NAME OF THE SECUNDARY SCHOOL-TOWN |
|
| NAME OF THE HIGH SCHOOL-TOWN |
|
| CURRENT EDUCATIONAL INSTITUTION |
|
| UNDERGRADUATE OR GRADUATE |
|
| WHICH CLASS ARE YOU ATTENDING |
|
|
WILL CREDIT BE SOUGHT FOR THE INTERNSHIP? IF YES, IS THE
INTERNSHIP COURSE REQUIRED FOR YOUR DEGREE PROGRAM? YES NO |
|
| REQUESTED INTERNSHIP DATES (START AND END) may be changed by
Palmiye Merkezi |
|
|
REFERENCES:Please
list two persons not related to you, who are familiar with your
character and qualifications: (Name-address-occupitation or
Business) |
|
| NAME, ADDRESS, E-MAIL AND TELEPHONE NUMBER OF THE PROFESSOR/ADVISOR
FOR THE COURSE |
|
| KNOWLEDGE OF LANGUAGES (TURKISH OR ENGLISH IS REQUIRED) |
|
| MARITAL STATUS |
MARRIED
SINGLE |
| DO YOU HAVE ANY HEALTH PROBLEMS, SPECIAL NEEDS OR ADDICTIONS? |
|
| HAVE YOU DONE INTERNSHIP BEFORE, IF THE ANSWER IS YES WHERE AND WHEN |
|
| WORD PROCESSING/COMPUTER SKILLS |
|
| IS THERE ANYTHING ELSE THAT YOU THINK WE SHOULD KNOW, OR THAT YOU
WOULD LIKE US TO KNOW ABOUT YOU? |
|
| DO YOU SMOKE? |
YES
NO
|
PERMANENT ADDRESS |
|
| TELEPHONE NO |
|
| E-MAIL ADDRESS |
|
Answers will be kept confidential for only personel purposes.
|
