UNHCR MOSCOW 
Internship Scheme
APPLICATION FORM
(YOU WILL BE CONTACTED ONLY IF UNHCR WISHES TO PURSUE THIS APPLICATION).
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 Family Name 
Happy Family  
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First/Given Name 
   Fathan 
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Gender
  (M/F) 
     Male 
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Date of Birth (Day/Month/Year) 
Monday,1 July 2002 
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Place of Birth 
Bandung 
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Present Nationality 
    Indonesia 
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Date available for internship. 
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From: 
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2017 
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To: 
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2018 
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Are you interested in a part-time internship?               Yes ( yes    ) 
  No  (     ) 
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What are your preferred areas of work?  1/ 
                                                                                        Anime Maker 
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What are your objectives in undertaking an internship with
  UNHCR? 
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I want to be an anime maker that can famous all of the
  world 
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Languages  - 
Mother tongue:   ____Indonesia________________________________
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Language Competence: 
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Read 
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Write 
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Speak 
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Understand 
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(specify) 
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Easily/Not Easily 
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Easily/Not Easily 
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Easily/Not Easily 
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Easily/Not Easily 
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Japanese                                   Not Easy               Not Easy               Easy                        Easy Easy                                         Easy
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1/  Select one (or up to five) area(s) :  
Refugee protection (legal) – Community & social services
– Research/policy analysis – -Translation & other language support –
Editing/publications –
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Higher Education (College and/or University, or equivalent)
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Institution 
(Name, Place,
  Country) 
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Month/Year
  Attended 
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  Degrees Obtained | 
  
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Major Subjects
  of Study 
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Anime Land 
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2017 
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Three degrees 
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anime 
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Degree(s) Expected: 
Career Plans:
I will make  a
character of anime
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Employment:  Please describe any previous practical experience
you may have had.
Draw anime just for fun
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-   3   -
Reference:  Indicate
the name of your scientific adviser or the Dean of the Faculty who can recommend
you for the internship and describe your character and qualifications.
Full Name                                                     Full
Address                                          Business
or Occupation
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Muhammad Fathan Wirdiyan                       Titiran Dalam Street  
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Anime maker  
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Your Address: 
Titiran Dalam Street number forty four 
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Telephone No.: 
081220536068 
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E-mail Address: 
Fathanwirdiyan098@gmail.com 
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Insurance:         
  I hereby confirm that I hold a health/accident insurance policy with
  the  
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       Allianz 
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Company.   My policy
  number is 
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   911 
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In case of emergency notify:  Name: 
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Muhammad Fathan W 
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Address/Telephone:081220536068 
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I certify that the statements
made by me in answer to the foregoing questions are true, complete and correct
to the best of my knowledge and belief.
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9 August 2017 
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                                 Signature 
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                             Date 
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