Work Experience Programme Application Form Long Term

Transcription

1 Work Experience Programme Application Form Long Term Please attach your passport photograph Name of applicant: Partner organisation: Nationality: Address: Date of birth: Telephone: Mobile: Driving Licence?? Yes? No If yes since when Do you smoke?? Yes? No Do you have any medical conditions / allergies?? Yes? No If yes please give details: What type of placement are you applying for? Please give 2 choices from the following: HORSES MIXED FARM DAIRY FARM AGRI-TOURISM* *Agri-tourism placements are seasonal (May/ June Sept) and available to Female applicants only 1 st choice 2 nd choice Start date: Finish date: Height: cm Weight: kg Height & weight are required for a horse placement, photos of you riding / jumping and/or handling horses will also be required

2 Please answer the following questions to help your host family understand your reasons for wanting to join their family. Does your family live on a farm? Describe it and the work you do on it. What are your career plans and how can this programme help you to achieve these aims? What is your ideal placement? We will not be able to find your ideal placement but we will try to find one as close as possible. What do you hope to learn in Ireland? Do you have friends in Ireland? If yes, where? Do you have a friend you would like to be placed close to? If yes, who?

3 Emergency contact information APPLICANTS NAME: Please provide the names and contact information of two people we can contact in the event of a crisis or severe illness Emergency contact 1 Name: Telephone number: Mobile number: Relationship to you: Address: Emergency contact 2 Name: Telephone number: Mobile number: Relationship to you: Address:

4 Guidelines and Checklist Please ensure that all forms are neatly and clearly completed. Remember your application and attachments are the first impression a host family will have of you. Arrival and departure dates should be accurate, but also flexible. Your application should be sent a minimum of 2 months prior to your requested start date. Once a suitable placement has been secured for you, Equipeople will send you a Placement Advice. You are not obliged to accept our offer however we will require a justified reason in order to find a more suitable placement for you. Please note that we charge a placement fee of 350. All fees must be paid before your arrival in Ireland. To ensure that your application is complete, please use this checklist. Application Form completed (Typed or written in black pen) Curriculum Vitae Clearly written or typed Motivation Letter*. Remember to include any relevant information for the type of placement you are applying for such as previous work experience, what you are studying, your home farm etc. *Letter of motivation: explain your reasons for coming to Ireland, what you are hoping to achieve, some information about yourself, your family, your interests, your experiences in your area of interest for your placement, your hobbies and anything that will help to know you as a person Passport photo A letter from your school/college/university confirming a period of work experience is a requirement or beneficial to your course of study Medical report Police check (preferable but not mandatory) Signed Terms & Conditions At least one reference letter, from someone who is not a family member and has known you for a minimum of 6 months Any relevant photographs, for example photographs of you riding, working with dairy cows, driving tractors/machinery Equipeople Limited, Garryhinch, Portarlington, Co. Laois, Ireland Ph: [email protected] If you have any questions about your application, please don t hesitate to contact us or the partner organisation in your home country.

5 Terms and Conditions 1. I declare that I am not suffering from any illness or disability apart from those listed on my application. 2. I understand that by coming on the Work Experience programme organised by Equipeople, I am not an employee but rather an extra pair of hands for my host family. Therefore I am not receiving a wage but pocket money, accommodation and meals with the family in return for my help. 3. I understand that the Equipeople Work Experience programme is not an employee programme but a cultural exchange programme and that my motivation in coming to Ireland is not to earn money but rather to see another country, improve my English skills, learn about Irish farming methods and to live as part of an Irish farming family. 4. I agree to treat my host family and their property with respect and by living in my host family s property; I agree to behave in a reasonable manner. I further understand that if the host family do not feel that I am the right student for them that they can ask me to leave at any time. 5. I understand that if for any reason I feel that my placement is not the correct placement for me, I should contact Equipeople who will endeavour to sort the problem out or find me a new placement. I also understand that it is not always possible for them to find me a placement within my first choice of placement and I may be offered a different type of placement. 6. I understand and accept that whilst Equipeople will have taken every care to place me with a suitable family, it accepts no responsibility whatsoever for any outcome at all arising from my choice to participate in the Equipeople Work Experience Programme or arising from the actions of my host family, the partner organisation / school in my home country or Equipeople itself. 7. I agree that any photos of me or letters from me to my host family, partner organisation in my home country or Equipeople may be used for promotional or marketing purposes including websites and brochures. 8. I understand that I may be dismissed from the Equipeople Work Experienced programme at any time for participating in illegal drug taking, drunken behaviour, endangering myself or any other person, committing a crime or any other behaviour deemed to be unacceptable by the director of Equipeople. In this event, I understand that all fees paid by me will be non refundable. 9. I agree that any fees charged by Equipeople will be paid in full prior to my arrival in Ireland. 10. I agree that I will be charged a cancellation fee if a placement is offered to me and I then choose to cancel from the programme. No cancellation fee will be incurred if I cancel before a placement has been offered. I declare that I have read and understood the Terms and Conditions listed above, and that I will comply with them accordingly. I declare that all information given in this entire application is accurate and complete. Applicant s signature Date I declare that that my son/daughter may participate in the Equipeople Work Experience Programme and I understand that Equipeople takes no responsibility whatsoever for any accidents or consequences of my son/daughter s participation in the programme. Parent/Guardian signature (if applicant is under 18 years of age)

6 Agricultural education If you are currently engaged in or have completed an agricultural education, please give details below. If you have a different background, please proceed to page First part of agricultural education (Grundforløb or equivalent) Period (dates) College attended/name and address of farmer Subjects/type of work College College 6. Second part of agricultural education (1. hovedforløb or equivalent) Period (dates) College attended/name and address of farmer Subjects/type of work

7 College 7. Third part of agricultural education (2. hovedforløb) Period (dates) College attended/name and address of farmer Subjects/type of work College Please remember to enclose photo copies of course certificates and references

8 To be completed by all applicants: Please give details of any schools attended (primary + secondary education) except for agricultural college already mentioned, and what you have done since. Give details of all courses and/or work experience, including those not relevant to agriculture (e.g. military service). Note: If you have filled in page 2, you need not repeat the information already given. 8. School Dates School Classes/courses 9. Dates Place of work/position Type of work 10. Please mark which of the following tasks you can perform on a scale from = very experienced, 2 = some experience, 3 = a little experience, 4 = no experience drive a tractor handle farm machinery drive combine harvester welding machine milking work with dairy cattle

9 work with beef cattle work with slaughter pigs work with sows Do you have a driving licence for: tractor automobile lorry/truck How long have you had your driving licence? Other tasks you can perform: 11. a) Have you ever worked/lived in another country? yes no If yes, please state country and period b) Have you ever lived away from home? If yes, how long? 12. Languages (level: 3 = excellent, 2 = good, 1 = poor, 0 = none, * = word-blind) English German French other languages Spoken Written

10 13. Other details Smoker Non-smoker Weight (kg) Height (cm) Special health problems: Please list all physical and/or mental disabilities (e.g. eye trouble, back pain, epilepsy, alleges, eating disorders) or any other health issues you may have. Do you have any disease that require regular medical treatment?: yes no If yes, please give details: Person to contact in case of emergency (name, address, tel. no.) To apply for a visa to some countries, you will be asked if you ever have been convicted of a crime. Please mark: I have been convicted of a crime I have not been convicted of a crime If yes, we ask you to enclose evidence of previous convictions. Note that this does not automatically prevent you from getting a visa. The Embassy will instead make a specific evaluation of your case. Were you raised on a farm? yes no If yes, Type of farm: Main crops: Size (ha): Type and number of animals:

11 14. Hobbies (sports, volunteer work, other) 15: Where did you hear about Travel to Farm? web page Meeting at your school From friends/family Agromek Material at your school 16. Enclose a short description of yourself, your interests, why you want to be a trainee in your chosen country in English (1 A4 page maximum) + a CV also in English. I undertake - to take out the necessary insurance (if it has not already been arranged by Travel to Farm or by the responsible trainee organisation in the host country). - to inform Travel to Farm and the host family as quickly as possible of any changes to the programme or travel arrangements etc. - not to change host family without consulting the responsible trainee organisation or Travel to Farm. - to be a worthy representative of my country and to follow all instructions issued by Travel to Farm and the responsible trainee organisation in the host country. - to pay all the invoices send by Travel to Farm (service fees, flight tickets, insurance) I understand that, if I leave my assigned training place without acceptable reason, no payment will be refunded. I agree that Travel to Farm is allowed to contact my references. Date Signature

12 Medical certificate (to be completed by a Medical Doctor) As a Working guest the applicant will be living with a family in a foreign country. It is therefore important that we are advised of any physical or mental health problems that may have a bearing on the applicant s ability to participate. Please review the information provided in Part 1 and give your opinion of the applicant s General state of health: Excellent Good Poor How long have you known the applicant? Is the applicant currently taking any medication? Please specify: Does the applicant have any infectious disease or suffer from any chronic illness? Has the applicant ever received treatment for nervous or emotional problems? I herby confirm that (please add the applicant s name) appears to be in good physical and mental health that allows him/her to work in a foreign country. Date, Location Doctor s signature and stamp 12