HOME > Networks in ASSITEJASSITEJ Next Generation Programme > Application form for placements Application form for placements The fields marked with a * are required.A application form for financial support is available after completing this stepOffer title Information about the applicantFirst name*Last name*Date of birth* Place of birth*Country of origin*Country of residence*Passport number*Origin of passport*Permanent address (as in passport)Street address*Adress line 2City*State / Province / RegionZIP*Country*Residencial address (if different)Current street addressCurrent street address line 2Current cityCurrent state / province / regionCurrent ZIPCurrent countryContact email* Phone numberPlease, use international format, i.e. +33 1234 567Website / Blog Mother tongue*Other languagesAre you a member of an ASSITEJ National Center?*YesNoAre you a member of an ASSITEJ Porfessional Network?*YesNoIf member, specify which National Center and / or Network Do you have any previous experience in the ASSITEJ programs? If "Yes", please specify which programShort CV* Motivation for application: Why do you want this placement?* Please note : If you are chosen for this offer, you are obliged to submit a report on your Placement experience to ASSITEJ International, the latest 2 weeks after your program has finished. The relevant data and photos from your application as well as the report can be published for evaluation and promotional activities of the ASSITEJ Next Generation Placements Program.You will be proposed to apply for financial support after submitting this formAnti-spam : are you human?