STUDENT APPLICATION FORM

PLEASE COMPLETE ALL SECTIONS USING COMPUTER

THE FORM MUST BE FILLED IN ENGLISH
PROGRAMME DETAILS
Project Name (please add also the project number)

Servicii de calitate prin dobndirea de competen e

cheie n context European Project
number: 2016-1-RO01-KA102-023921

Arrival Date

Departure Date

24/03/2017

First Name

Silviu-Cristinel

06/03/2017

No Months/Weeks/Days

3 weeks

PERSONAL INFORMATION
Family Name

Maria-Afrem

Date of Birth

06/10/1999

Place of Birth

Craiova, Jud. Dolj

Nationality

Romanian

Sex

Male

Marital Status

Married

Mun. Craiova, Jud. Dolj, Str. Calea Bucureti

no. 34, Bl. A8, Sc. 2, Ap. 7

Address

Female
Single

City

Craiova

Post Code

200473

ID Number

DX 990250

Country

Romania

Mobile

(+40) 0743 111 854

Telephone

(+40) 0743 111 854

Email

silviu.afrem99@gmail.com

Skype

Do you have a
driving license?

Yes

No

WHO SHOULD WE CONTACT IF THERE IS AN EMERGENCY?

Name

Maria-Afrem Maria-Magdalena

Address

Mun. Craiova, Jud. Dolj, Str. Calea

Bucureti no. 34, Bl. A8, Sc. 2, Ap. 7

Relationship

Married

City

Craiova

Country

Romania

Post Code

200473

Telephone

(+40) 0748 879 390

Mobile

(+40) 0748 879 390

Email

mariaafremmaria78@gmail.com

YOUR HEALTH
Do you have any special dietary needs?

()

Do you have any allergies?

()

Do you have any special needs?

()

Do you Smoke?

()

Yes

No

If yes, please tell us about them:

Yes

No

If yes, please tell us about them:

Yes

No

If yes, please tell us about them:

Yes

No

Are you taking any regular medication?

()

Are you receiving any medical treatment?

()

Yes

No

If yes, please tell us about them:

Yes

No If yes, please tell us about them:

YOUR WORK PLACEMENT REQUIREMENTS

Your conditions of employment will be determined by the employer and you will be required to abide by these. Do you understand and agree to this?
()
Yes
No

Please state the subjects and courses, which form a part of your practical training (art history, economics, ect.)
Economics, marketing, organization of activity in tourism
Please state the type of jobs, field of jobs, companies and firms where you could be employed after having finished
your current studies
Please state the sectors you would like to be placed (e.g. administration, finance, marketing, tourism, etc)
Choice #1: tourism
Choice #2: marketing
Please indicate which tasks you would like to carry out:

preparing promotional materials and displays, planning, selling

Please indicate if you have any previous experiences in the sectors mentioned above:
I dont have any experience in the sectors mentioned above.

YOUR ACCOMMODATION
During your stay, you will be responsible for any damage you cause to the property, and will be expected to contribute to the cleanliness and tidiness of
your accommodation. Do you understand and agree to this?
()
Yes
No
During your stay you will be responsible for the safety and security of your own personal possessions, including your money, travel tickets and passport or
identity card. Do you understand and agree to this?
()
Yes
No

EDUCATION
From

To

Name of School/Training

Exams passed and grade

15/10/2005

15/06/2014

General School Nr. 39 Nicolae

Blcescu

National evaluation

15/10/2014

Present

National Economic College

Gheorghe Chiu

Please list your computer skills:

-

Corel Draw - begginer

Microsoft Word

Microsoft PowerPoint

Photoshop beginner

E-Mail

Language levels level correspond to the council of Europe s common European framework

English

Beginner

Beginner - assumes no previous study in English

Basic user

A1 Elementary you can deal with very limited day- to-day activities
A2 Lower intermediate you can deal with predictable day-to-day activities

Other Languages

Independent
user

B1 Intermediate you can deal with varied familiar everyday activities

Proficient
user

C1 Advanced you can deal with complex work tasks

#1: Mother
tongue:

B2 Upper intermediate you can deal with simple key work tasks
C2 Proficiency you can use the language fluently, accurately and appropriately
romanian

#2: French

Beginner

A1

A2

B1

B2

C1

C2

#3: Italian

Beginner

A1

A2

B1

B2

C1

C2

#4:

Beginner

A1

A2

B1

B2

C1

C2

WORK EXPERIENCE
Company/Activity

From

To

Responsibilities

Have you ever worked abroad? ()

Yes

No If yes, please give details:

YOUR HOBBIES, INTERESTS AND ASPIRATIONS

Please tell us a little about your hobbies, interests and what you do in your spare time:
-reading
-listening music
-drawing
-playing games
YOUR FUTURE
What do you want to do at the end of your studies?
At the end of my studies I want to get a well-paid job and to travel. Later I would like to write and anonimously publish a book,
see if people will like it. But mainly I want to have a peaceful life.

STUDENT DECLARATION
I certify that the information I have given in connection with this application is true and correct. I give my permission to 1CEBA to use this information to
fulfil my requirements and agree to this information being passed to other people and organisations as necessary.

Name and Surname: Silviu-Cristinel Maria-Afrem

Date: 09.01.2017