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Foreign Passport Data

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(Please fill in the form on computer in English)




1. Full name ___________________________________________________________

Family First Middle

2. Male/Female _____________________________

3. Date of Birth ________________________________________________________

Date Month Year

4. Marital Status _______________________________________________________

5. Home Address _______________________________________________________


6. Home and/or Contact Telephone (including Area Code) _______________________

7. Mobile phone_____________________________

8. Office Telephone __________________________

9. e-mail ___________________________________

10. Skype (if you have it)_____________________________

11. Company Name ______________________________________________________

12. Length of Employment with this Company, since ____________________________

13. Total Length of Employment as a Manager _________________________________

14. Position _____________________________________________________________

15. Please describe your professional responsibilities and duties, and your position in the organisational scheme (attach an organogram of your company on a separate page)


16. Number of stuff you are directly responsible for ______________________________

17. Does your company have your personal development plan? YES NO

18. Does your company have your department development plan? YES NO

19. Foreign Language Capability


(Basic, Good, Fluent - please underline)

Degrees as written in the undergraduate Diploma (copy provided)


(Basic, Good, Fluent - please underline)

Degrees as written in the undergraduate Diploma (copy provided)


20. Education: (please start with your most recent degree/professional qualifications)

Name of University or College, Address Department Year of Admission Year of Graduation Degree


19. Other Training Programs, including Training in a Foreign Country:

Name of Institution Name of Program Year Length of Program Certificate (Y/N)

19.1 Degrees as written in the Diploma on retraining within the Presidential Program.



20. Have you participated in any other international programs? If yes, please specify.



21. Work experience: (please start with your most recent job)

Month, Year Start Month, Year End Company, Position Address of Company



22. Training Objectives:

Specify internship objectives (be as specific as possible):






23. Describe the projects/actions you plan to implement after training.



24. Do you already have the commitment of your CEO for such projects? (Attach letter of recommendation)



25. Which factors will have positive or negative impact on the change process in your company?



26. Do you have any preferences regarding the country of internship?

If YES, please indicate


Candidate's Signature___________________________ Date __________________



Foreign Passport Data

(Fill in the form or enclose a copy of your foreign passport)


In Russian In English
Фамилия Last Name
Имя First Name
Отчество Middle Name
Дата рождения Date of Birth
Место рождения Place of Birth
Гражданство Nationality
№ паспорта Passport #
Место и дата выдачи паспорта Issued (place and date)
Дата окончания срока действия Expiration Date
Вид паспорта (общегражданский, служебный, дипломатический) Type of Passport



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