There should be a consensus between the participant and his/her employer concerning the objectives of joining the programme.

For this reason, we kindly ask you to jointly formulate your objectives Candidate profile

Please fill in the form digitally in English and return as a pdf document Please attach a copy of your passport Please attach a photo of yourself as a jpeg file If your enterprise has a (digital) company brochure, please attach

Last name: Patronymic name: First name(s): Gender: Date of birth: Home address: Zip/postal code: Place of residence: Oblast: Co ntry of citi!enship: Cell phone: Home and/or contact telephone: Office telephone: "#mail address: Company name: $ebsite company: %ector: Prod ct/acti&ities: C rrent 'ob title: (eportin) to: Ho* many direct reports:

male female

+otal amo nt of s bordinates to mana)e: ,ears of employment *ithin the company:

Description of professional responsibilities and d ties: Personal goals -re yo a&ailable d rin) the follo*in) periods. First *ee/ trainin) ( ssia: +rainin)/internship +he 0etherlands:

,es ,es

0o 0o

Profile of the D tch host company yo r enterprise is interested in establishin) contacts *ith: 1f yo r enterprise has established b siness lin/s / contact *ith a D tch company *hich is ready to host yo as a candidate2 please indicate: $hat type of internship assi)nment has yo r preference. $hat are yo r main personal ob'ecti&es d rin) the internship. Form late *hat yo *o ld li/e to learn d rin) the internship in the 0etherlands: Ho* *ill yo r company benefit from the president3s Pro)ramme. Form late *hat yo can offer a D tch host company d rin) and after the internship in +he 0etherlands: "4plain ho* yo r personal de&elopment )oals and yo r career path correspond to the de&elopment )oals of yo r company: Do yo already ha&e the commitment of yo r C"O for s ch pro'ects/actions. (Please tic/ the appropriate bo4): ,es 0o Work experience (please start with your most recent job): Company Position Date start Date end Duties (in short)

ducation (please start with your most recent degree!professional "ualifications):

#ame of $ni%ersity or College& 'ddress

Department

(ear of 'dmissio n

(ear of Degree )raduation (!#

*raining programmes& including training in a foreign country: #ame of institution #ame of programme (ear +ength of programm e Certificate (!#

Have you followed (a part of this training programme before! "f yes, which programme, what month/year# ,oreign language proficiency: ,oreign +anguage -other tongue .asic /ntermediate ,luent

Place

Date

%i)nat re candidate

There should be a consensus between the participant and his/her employer concerning the objectives of joining the programme. For this reason, we kindly ask you to jointly formulate your objectives Company profile

Candidate3s name: F ll name of the company: Company address: Postal code: +o*n/city: "conomic re)ion: $ebsite company: Contact telephone: "#mail: 0ame of C"O: +elephone n mber C"O: "#mail address C"O: Description of the company

O*nership str ct re (please tic/ the appropriate bo4): %tate company Pri&ate company 5oint stoc/ company Holdin) 5oint &ent re ,ear of establishment: %ector (please tic/ the appropriate bo4) a)ric lt re a tomoti&e constr ction creati&e ed cation finance food processin) )as/oil/ener)y health care ind stry

1+ lo)istics maritime media/entertainment real estate ser&ices to rism trade transport *ater other (please specify): Prod ct/%er&ices and their percenta)e of the ann al o tp t Credit 6 Deposit 6 Profile of yo r department/di&ision: -nn al t rno&er (appro4imately2 in " ros): 0 mber of employees in yo r company: 7889 788: 788; 788< 788= 78>8 78>> 0 mber of employees in yo r department/di&ision: Ho* s ccessf l is yo r company (please tic/ the appropriate bo4) ?ery s ccessf l (ather s ccessf l +here are some diffic lties +here are serio s problems $hat /ey challen)es is yo r company facin). Other information (please describe any chan)es *hich ha&e ta/en place in yo r company in the last fi&e years):

/nternational contacts 1f there is any forei)n in&estment in yo r company2 indicate from *hich co ntry/co ntries: and *hich company/companies: $hat is the percenta)e of the forei)n in&estment: 6 Lon) term forei)n partners (company3s f ll name2 co ntry2 address2 phone / fa42 e#mail2 contact person and his/her position2 e4act nat re of relationship bet*een companies):

"4port as percenta)e of ann al o tp t: Forei)n mar/ets and co ntries: Has yo r company participated in any international pro)ramme or recei&ed help from international pro)rammes. 1f so2 please specify: Statement by the employer. a@ 12 the ndersi)ned2 bein) a thorised to s pply the follo*in) partic lars2 here*ith certify that Ar/As is employed by my or)anisation@ b@ I, the undersigned, am aware of the fact that applicants who have been accepted for the course are e pected to duly attend. In case of no!shows or cancellations within " wee#s before the course commences, the course organiser has the right to claim all costs incurred from the candidate$s employer (the above applies to the start of the course in %ussia as well as the start of the course in &he 'etherlands). c@ 1 consider the trainin) to be important for the applicant3s *or/ and o r or)anisation beca se of the follo*in) reasons:

Date:

Position:

0ame of or)anisation:

%i)nat re and official stamp:

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