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Home and Staff
2020-08-08T17:16:23+02:00
Last Name* :
First Name* :
Maiden Name :
Phone Number :
Mobile Number* :
Email* :
Which ad are you applying for?* :
Sex* :
Man
Woman
Marital Status* :
Single
Married
Pacsé(e)
Widowed
Separated
Divorced
Marital Life
Date of Birth* :
Place of Birth* :
Birth Department* :
Country of Birth* :
Retired* :
oui
non
Student* :
oui
non
Address No. and street* :
Additional Address :
Postal Code* :
City* :
Country* :
DOWNLOADABLE DOCUMENTS
Banking document in your name :
Social Security Card :
Valid Mutual Certificate ACS/CMU :
Passport or Identity Card (both sides) :
Visa
or
Resident Card
or
Resident Card :
Professions practiced* :
140
Availability Dates (between June and December)* :
TRANSPORT
Means of Locomotion* :
yes
no
If yes, which one?
Accept carpooling* :
yes
no
Wish carpooling* :
yes
no
Accompanied by :
HANDICAPPED WORKER
Recognized Disability * :
yes
no
If yes :
Disability Rate (in %) :
Download Disability Card :
Category COTOREP :
EMERGENCY CONTACT
Last Name* :
First Name* :
Family Link* :
Phone Number* :
Further information :
*: Mandatory field
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