Bureau d`Assistance Technique SOCRATES, LEONARDO

SOCRATES, LEONARDO & JEUNESSE
SOCRATES, LEONARDO & YOUTH Technical Assistance Office
Bureau d'Assistance Technique
IC ASSESSOR APPLICATION FORM
Would you be available to work for a 3 week period (assessment of proposals) or 4-10 week period (Final
Report analysis)? Please indicate:
3 week period
4-10 week period
PERSONAL DETAILS
First Name:
Date of Birth:
Surname:
Nationality:
PRIVATE ADDRESS:
Address:
Post code and city:
Country:
Private Phone Number:
Private Fax Number:
Private email:
@
OFFICE ADDRESS:
Organisation:
Department:
Address:
Office Phone Number:
Fax Number:
Email Address:
@
Country:
WORKING EXPERIENCE
Current position:
Previous positions (please do only describe those relevant to the above applied position).
EDUCATION (Higher Education degrees only)
59-61, rue de Trèves/Trierstraat, 59-61
B-1040 Bruxelles/Brussel
http://www.socleoyouth.be
Tél: (+32)(2)233.01.11
Fax: (+32)(2)233.01.50
The Socrates, Leonardo & Youth Technical Assistance Office is part of the ETAPE Consortium which assists the European Commission
in the technical management of the Socrates, Leonardo da Vinci and Youth programmes.
Le Bureau d’Assistance Technique Socrates, Leonardo & Jeunesse fait partie du consortium ETAPE qui assiste la Commission européenne
dans la gestion technique des programmes Socrates, Leonardo da Vinci et Jeunesse.
SOCRATES, LEONARDO & JEUNESSE
SOCRATES, LEONARDO & YOUTH Technical Assistance Office
Bureau d'Assistance Technique
LANGUAGES: Please mention any language with the corresponding level (from "1: beginner" to "5: mother tongue")
Language
Reading
Listening
Speaking
Writing
COMPUTER SKILLS: Please list briefly the computer software that you are familiar with.
PREVIOUS EXPERIENCE IN ASSESSMENT or EUROPEAN COOPERATION activities (please mention where, when,
what if applicable)
(The Socrates, Leonardo and Youth TAO, guarantees the confidentiality of this information.)
V2.1
59-61, rue de Trèves/Trierstraat, 59-61
B-1040 Bruxelles/Brussel
http://www.socleoyouth.be
Tél: (+32)(2)233.01.11
Fax: (+32)(2)233.01.50
The Socrates, Leonardo & Youth Technical Assistance Office is part of the ETAPE Consortium which assists the European Commission
in the technical management of the Socrates, Leonardo da Vinci and Youth programmes.
Le Bureau d’Assistance Technique Socrates, Leonardo & Jeunesse fait partie du consortium ETAPE qui assiste la Commission européenne
dans la gestion technique des programmes Socrates, Leonardo da Vinci et Jeunesse.