AgriLida

Programs


Personal data
Surname:	Name:	Date of birth:
Nationality:	Religion:	Citizenship:
Sex:	Marital status:	Military:
International Passport
Number Emitted by Date of emission Valid until
Did you have an International Passport before?
If YES, please indicate its number and validation period
Do you have any experience working abroad?
If YES, please indicate the name of the programme and when and where it was held:
Have you had a restriction on entering any country?
Personal Identification
Number: Identification Code: Emitted by: Date of emission: Valid until:
Postal address
Telephone E-mail Mobile
Parents
Postal address of your parents
Father`s name Mother`s name
Telephone E-mail
Studies
Educational institution/ town
Address
Faculty Department
Years of study Group Year of admission Year of graduating
Average mark Phone number of the faculty in your University
Skills, qualifications
Driver's license ( indicate the category ) A B C D E H
Others diplomas,certificates, qualifications, skills
Foreign languages
English French German Romanian Russian Other languages
Work experience

21. Please, choose and tick three types of work you wish to participate within the programme Pig farming Dairy farming Poultry farm Fodder production Horse breeding Cow rearing Gardening, horticulture Cultivation of field crops Others * - Number of places are limited
What time are you available? (submit this to the dean of your faculty)
Please, indicate motivation of your participating in the programme, organized by ACORD.
Photo
Validation code:
* -

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