Step 1: Enter the requested information below:
This application form contains the following sections:
- Contact Information
- Personal Details
- Present University Education
- Previous Education Above Primary School
- Language Skills
- Activities
- Computer Knowledge and Experience
- Experience of CERN
- Motivation
- References
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1.
Contact Information:
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First
Name:
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Family
Name:
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Home
address:
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Address
for all correspondence:
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Telephone (work):
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Telephone (home):
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Fax:
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Electronic
mail:
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2.
Personal Details:
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Sex:
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Maiden
name (if applicable):
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Date
of birth:
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City
of birth:
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Country
of birth:
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Nationality:
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Marital status:
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3. Present
University Education:
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Institution:
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Town:
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Country:
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Attended:
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from to
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Grade Point Average (out of 4.00):
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Degree anticipated:
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When:
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Will you continue studies after Summer 2009?
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No
Yes: |
| How many years of full-time study at university level will you have completed by Summer 2009?
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Main
field of study:
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| Specify: |
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Remarks about your course of study:
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4. Previous
Education Above Primary School:
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5. Language
Skills:
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| Mother tongue: |
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6. Activities:
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Choose three activities in order of priority:
1.
2.
3.
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7. Computer
Knowledge and Experience
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Word processing:
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Other software packages:
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Computer languages:
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Hardware:
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Operating systems:
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8. Experience
of CERN
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Have you worked at CERN before ?
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No
Yes: |
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Are you involved in an experiment
at CERN?
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No
Yes: |
9. Motivation
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| Please write a single paragraph
describing why you would like to do research at CERN this summer:
Describe any relevant work experience
obtained during your studies and/or training periods:
Describe as precisely as possible the kind of
work you would like to do at CERN:
How/where did you learn about the CERN Summer
Student Program?
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10. References
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Contact information for first reference
Contact information for second reference:
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Press this button when you are finished:
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