Internship Application Form

All fields with * are required!
1. Personal Data
  First name: *
  Last name: *
       
2. Current Address / Contact
  Street: *
  2. Address
  City / Town: *
  State/Region/Province
  Zip code: *
  Country: *
  Phone: *
  Mobile:
  Email: *
  Personal web site:
       
3. Education / University Education (recent education)
  University name: *
  Location: *
  Field of Study: *
  Major: * (please write out no abreviations)
  Specialization/ Minor:
  Degree: *
  Start of study: *
(mm/dd/yyyy) 		 
  End of study: *
(mm/dd/yyyy) 		 
  If you are still studying, which semester are you in?
       
4. Work and Practical Training Experience
  Have you been previously employed by Siemens? *
yes
 no
   
  I. Work and Practical Training Experience
  Company name: *
  Company industry: *
  Department: *
  Position title:
  Contact Person:
  Contact Person Phone:
  Start: *
(mm/dd/yyyy)		  
  End: *
(mm/dd/yyyy)		  
  Work description: *
(Maximum 500 characters)
       
  II. Work and Practical Training Experience
  Company name:
  Company industry:
  Department:
  Position title:
  Contact Person:
  Contact Person Phone:
  Start:
(mm/dd/yyyy)		  
  End:
(mm/dd/yyyy) 		 
  Work description:
(Maximum 500 characters)
       
  III. Work and Practical Training Experience
  Company name:
  Company industry:
  Department:
  Position title:
  Contact Person:
  Contact Person Phone:
  Start:
(mm/dd/yyyy) 		 
  End:
(mm/dd/yyyy) 		 
  Work description:
(Maximum 500 characters)
       
5. Apprenticeship
  Company name:
  Company industry:
  Department:
  Degree:
  Contact Person:
  Contact Person Phone:
  Start:
(mm/dd/yyyy) 		 
  End:
(mm/dd/yyyy) 		 
  Apprenticeship description:
(Maximum 500 characters)
       
6. Qualifications
 
  Language Spoken Written
1*
2
3
4
       
 
ITSkills Skill level ITSkills Skill level
Access Java
Excel HTML
Powerpoint Perl
Word Cold Fusion
Windows 2000 Dreamweaver
Windows XP Flash
Windows 2003 Photoshop
SAP Linux/ Unix
SQL Visual Basic
C PHP
C++ Delphi
C# SPSS
other
       
  Professional Certificatons
 
Certificate Program Name Year obtained
 
 
  Hobbies and extracurricular activites (Maximum 250 characters)?
   
       
7. Additional Information
  Are you a member of a Siemens student program? *
Yes
 No
  Period available for internship *  
 
From
(mm/dd/yyyy)
  
 
To
(mm/dd/yyyy)
  
  Which area are you interested in (e.g. Finance, Marketing, Sales, etc.)
 
1.*
 
2.
 
3.
       
8. Cover Letter
  Copy and paste your cover letter (max. 500kB) *
       
9. Attachments
  Attach your resume:*
(max. 500kB, PDF/DOC/TXT)