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application-profile |
Ärzte
der Welt e.V. Médecins du Monde Deutschland Thalkirchner Str. 81 / KH I 81371 München Telefon: +49 89-62 42 09 55 Telefax: +49 89-65 30 99 72 www.aerztederwelt.org info@aerztederwelt.org |
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| first
name: ....................................... |
name: ......................................... | Photo |
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| street: ........................................... | zipcode/town ............................... | |||
| phone: ............................................ | fax: ............................................. | |||
| born: .............................................. | nationality:
................................ |
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| family status: ................................ | children:
..................................... |
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driving licence: car, up to 7,5 t truck, international |
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| employed
at: .................................. |
as:
.................................................. |
phone:
...................................... |
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| languages: | english |
 very good |
good |
a bit |
| french |
very good |
good |
a bit |
|
| spanish |
very good |
good |
a bit |
|
| other
................ |
very good |
good |
a bit |
|
| previous
engagements > 6 mon. for an NGO, country, NGO,
function, duration? ........................................................................................................................................................................... ........................................................................................................................................................................... ........................................................................................................................................................................... possible engagements: up to (date): ..................... for < 2 mon. 4-6 mon. > 6 mon. ................ adress / phone of the next of kin: ........................................................................................................................................................................... ........................................................................................................................................................................... ........................................................................................................................................................................... notes: ........................................................................................................................................................................... ........................................................................................................................................................................... ........................................................................................................................................................................... town / date: ................................................ signature: ............................................. |