Google EmployAbility Sales and Other Non-Technical Internships2011
Please complete this application form as fully as possible. Fields with an asterisk (*) are mandatory and must be completed. To be eligible for this programme you must be a university student and have a disability.
Once completed, please send this form to EmployAbility with a copy of your CV via email to
Deadline for applications is 15 February2011.
If you require an alternative method of submitting this form,or if you have any query, please contact Justin Penney at EmployAbility on +44 (0)7776 090 508.
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Role(s) you are applying for
Please indicate which Google role(s) you are applying for and the location as described in the ad. For each location, please indicate whether you have or can obtain work authorisation.
1st choice:
Role
Location
Work authorisation
2nd choice:
Role
Location
Work authorisation
3rd choice:
Role
Location
Work authorisation
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Languages
Please list all languages in which you are fluent:
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Availability
When are you looking to start your placement and for what duration?
Possible start dates (mm/yyyy)
Duration: to months
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Personal Information
First Name*
Middle Name
Last Name*
Address 1*
Address 2*
City*
County
Postcode*
Country
E-mail Address*
Mobile*
Main Telephone Number
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Educational Background
Undergraduate Degree & Subject(s)
University
Year of Study
Graduation Year
Degree Grade/Class or GPA
Postgraduate Degree & Subject(s)
University
Year of Study
Graduation Year
Degree Grade/Classor GPA
Transcript
For immediate consideration, please submit a copy of your transcript or, if unavailable, a detailed summary of results you have achieved in all courses taken during your university education.
CourseResult
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Employment History
Employer Name
Job Title
Start Date (mm/yyyy)
End Date (mm/yyyy)
If you are still employed by this employer leave end date blank
Employer Name
Job Title
Start Date (mm/yyyy)
End Date (mm/yyyy)
If you are still employed by this employer leave end date blank
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Cover Letter – please insert below
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Disability Information
Please provide details of your disability*
To be eligible to apply through EmployAbility you need to have a disability or health condition as defined under the Disability Discrimination Act 1995
Please provide details of adjustments or support required in the workplace
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Marketing
How did you first hear about this Google EmployAbility programme?
EmployAbility: Newsletter / Email
Telephone / text
Facebook / Twitter
Website – via search engine
Website - directly
Graduate / Careers fair
Campus Visit / Skill session/ Workshop
Prospects.ac.uk
Google website
University Careers/Disability Office or Website
Website or Publication (please state)
Other (Please state – eg word of mouth)
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