The Institute For International Criminal Investigations International Investigator Course Application Form
The Institute For International Criminal Investigations International Investigator Course Application Form
NB: Please do not use this o!" i #ou $ish to a%%l# o! a s&hola!shi% ' use the S&hola!shi% A%%li&ation o!" instead( Pe!sonal details: First name: Family name: Date of birth: Place of birth: Current Address )NOT A PO Bo* Please+ Previous address if less than three years: Nationality: Country of residence: Male / Female: Languages spo en: !elephone Mobile: numbers "ome: #usiness: $mail address: Edu&ational ,a&-.!ound: %nstitution: Se&onda!# / Te!tia!# Main course of study:
'ears attended:
Address:
(ccupation:
Dates of employment:
Re e!ee details: Current )upervisor: Name: Previous )upervisor: Name: Personal *eferee +,: Name: Personal *eferee +-: Name:
Address:
Position:
!elephone number:
$mail address:
Address:
Position:
!elephone number:
$mail address:
Address:
Position:
!elephone number:
$mail address:
Address:
Position:
!elephone number:
$mail address:
Anna Paulo&nastraat ,./0 -1,2 #C !he "ague0 Netherlands tel3 4/,56.5/78877. Fa9 4/,56.5/7/-/.. iici:iici3info
Ba&-.!ound 0uestions: Are you0 or have you been a member of the armed forces of any country; No / 'es0 in the past / 'es0 currently %f yes0 name of the armed force0 ran and type of duties performed: "ave you ever been involved in an armed conflict; No / 'es0 in the past / 'es0 currently %f so0 &hen0 duration0 role; <ere you involved in or did you &itness any violations of international humanitarian la& or of the =eneva Conventions; No / 'es0 involved / 'es0 &itnessed Are you0 or have you been a member of an intelligence or security service of any country; No / 'es0 in the past / 'es0 currently %f yes0 name of the service0 position and type of duties performed: "ave you ever been charged &ith a crime; 'es / No %f yes0 please provide details3 Pe!sonal State"ent: !his statement should e9plain ho& you might benefit if you are given the opportunity to participate in this training0 and ho& you plan to use the no&ledge and e9perience ac>uired during the training3 ?se -.. &ords ma9imum:
Ce!ti i&ation: % hereby certify that the personal information % have provided in this form relates to me and is true and correct: )ignature:@@@@@@@@@@@Date:@@@@@@@33@@@@ Consent: % hereby consent to the %%C% ma ing en>uiries &ith my employer and referees to confirm the information provided in this application form and also to determine my suitability to attend an %nternational %nvestigator Course3 )ignature:@@@@@@@@@@@Date:@@@@@@@@@@@@
<hen applying for the %nternational %nvestigator Course please send the follo&ing documents to iici:iici3info 5 5 5 'our CA A ,5- page document in $nglish0 &ritten by you !his application form0 filled out in <ord BNot in PDF pleaseC
*e>uired additional information %%C% also &ishes to receive one letter of recommendation from one of your referees3 *ecommendation letters should be sent directly by the recommender to iici:iici3info Bas e5mail te9t0 not as attachmentsC &ith the name of the applicant in the subDect header line of the email3 !he name0 title0 position and other relevant details of the recommender should also be prominently displayed3 #oth a telephone number and the email address of the recommender should be included3