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????????????????????????????????? APPLICATION FORM

PLEASE READ THE INSTRUCTIONS FIRST:

Instructions:?

Estimated time to fill is 20-30 minutes. You may also need some extra time to think about your answers. Therefore, you have two options in filling the form:

First option. You may save this form on your computer by clicking "File" and then "Save As" in your browser. After you saved the form on your computer, open it in your Microsoft Word or Word Perfect program and answer the questions. Once you are finished, save it with your last name as file name and with .htm as an extension. For example, if your name is Gucci, the file name should be gucci.htm. Send the file as an attachment to ?

Second option. You may fill the form and click "Send to MIM" button.

First name
Last name
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Country Phone Code?
Phone
FAX (optional)
E-mail
Nationality
Permanent resident of
Native language?
Other languages spoken (please indicate level of proficiency from basic, 1, to perfect, 5)?
Birthday (month/day/year)
Education
Name of Your College (University)
Your College's Phone

Dates of attendance

Title of diploma and date conferred

Academic honors (briefly describe scholastic distinctions or honors you have earned in high school or college)

Total years and months of work experience

years months

Name (-s) of the company (companies)

Tasks (including position and duties)

Extracurricular skills and activities

?Online internship profile (please express your wishes below)

Industry (please give three choices)

Department/Duties

Any specific company (companies)?

What do you expect to learn?

When do you want to start your internship and how long would you like to do it?

Online courses

In which course (courses) do you plan to enrolled?
How do you want to start and follow your courses

When do you want to start your courses?

Please submit a brief statement (200 words maximum) indicating your educational and personal goals, and how can our online program help you in fulfilling them.

How did you hear about M.I.M ? (multiple answers are possible)

Internet???? Friend???? Through your school?? MIM Alumnae

Other (please explain)

Would you like us to contact other person(-s) you know who could be interested in the internship or classes? (please put as many e-mail addresses as you wish)

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