Internship Application Form

(Office of the Prosecutor)

Please indicate the section/unit where you would like to complete your internship
You may select only three sections or units in total, please rank your three choices. Please note that preference for one particular section/unit does not preclude consideration by or placement to another section/unit.
Section/Unit / Preference
1st / 2nd / 3rd
Immediate Office of Prosecutor
Immediate Office of the Prosecutor (Public Information)
Legal Advisory Section
Services Section (Information Evidence Unit)
Services Section (General Administration)
Services Section (Language Services Unit)
Jurisdiction, Complementarity and Cooperation Division
Investigation Division
Prosecution Division
This application is in response to a Special Call for Application / Reference:
PERSONAL DETAILS
1.  Family name(s) / 2.  First (and middle) name / 3.  Sex / 4.  Date of birth (dd,mm,yy) / 5.  Place of birth
6.  Present nationality(ies): / 7.  Marital status:
Single Married Separated Widowed Divorced
8.  Permanent home address (incl. telephone no.): / 9.  Present address (incl. telephone no.):
10.  Email address: / 11.  In case of emergency notify (incl. telephone no.):
AVAILABILTY FOR INTERNSHIP
12.  Please indicate your preferred start and end dates for your internship placement.
From: To:
13.  Please also indicate the earliest and latest dates you are available to start and end the internship placement
Earliest start date: Latest end date:
14.  What is your preferred field of work (e.g. research, drafting speeches, administrative work, legal analysis etc)?
LANGUAGE SKILLS
15.  What is your mother tongue?
16.  Other language skills / READ / WRITE / SPEAK
Basic / Intermediate / Advanced / Basic / Intermediate / Advanced / Basic / Intermediate / Advanced
EDUCATION.& TRAINING
17.  University or equivalent
NAME, PLACE and COUNTRY / ATTENDED FROM/TO / DEGREES and ACADEMIC DISTINCTIONS OBTAINED / MAIN COURSE OF STUDY
Month/Year / Month/Year
18.  Schools or other formal training from age 14 (e.g. high school, technical school or apprenticeship)
NAME, PLACE and COUNTRY / TYPE / ATTENDED FROM/TO / CERTIFICATES OR DIPLOMAS OBTAINED
Month/Year / Month/Year
WORK EXPERIENCE
Please include all work experience, including present employer/placement if applicable. Continue on a separate page if necessary.
EMPLOYER/PLACEMENT DETAILS / Dates (Month/Year) / Paid employment* / Funded Internship**
From / To / *Net annual salary / **Sponsor details
Voluntary work / Unfunded internship
Summary of main duties
EMPLOYER/PLACEMENT DETAILS / Dates (Month/Year) / Paid employment* / Funded Internship**
From / To / *Net annual salary / **Sponsor details
Voluntary work / Unfunded internship
Summary of main duties
EMPLOYER/PLACEMENT DETAILS / Dates (Month/Year) / Paid employment* / Funded Internship**
From / To / *Net annual salary / **Sponsor details
Voluntary work / Unfunded internship
Summary of main duties
EMPLOYER/PLACEMENT DETAILS / Dates (Month/Year) / Paid employment* / Funded Internship**
From / To / *Net annual salary / **Sponsor details
Voluntary work / Unfunded internship
Summary of main duties
EMPLOYER/PLACEMENT DETAILS / Dates (Month/Year) / Paid employment* / Funded Internship**
From / To / *Net annual salary / **Sponsor details
Voluntary work / Unfunded internship
Summary of main duties
19.  List activities in civic, public or international affairs
20.  List any significant publications (please do not attach copies of these to your application)
21.  Career Plans - please provide a brief summary of your career aspirations
REFERENCES
You are required to submit two written references with your application, one should preferably be academic. Please provide full details of the referees providing the references below. NB referees should not be relatives
FULL NAME and TITLE / FULL PROFESSIONAL ADDRESS / BUSINESS OR OCCUPATION
22.  Do you have any objections to the Court making inquiries to your present employer/supervisor? YES NO
FINANCIAL ASSISTANCE
The Court has limited funds to provide financial assistance to those applicants deemed most in need of financial support in order to take up an offer of an internship. The funds are made available by a grant from the European Union and supplemented by donations from the governments of The Netherlands, Switzerland, The Republic of Korea, Finland, and the MacArthur Foundation. Successful applicants receive a stipend of €1000 per month to assist with the costs of living in the Hague; travel costs and emergency medical insurance is also covered under this grant.
23.  Do you have sufficient financial means (sponsorship, personal savings or parental support) to enable you to cover the costs of an internship in The Hague? YES NO
24.  Do you wish to be considered for financial assistance under the terms of the grant? YES NO
25.  Please detail any efforts that you have made to secure sponsorship or third party funding for a potential internship at the Court.
26.  Please provide any additional information that is relevant to your financial situation that should be taken into consideration by the selection committees assessing the eligibility of applicants.
27.  Would you accept an internship at the Court without a stipend? YES NO
28.  SECURITY QUESTIONS
a) Passport Number:
b) Have you ever been arrested, indicted, or summoned into court as a defendant in a criminal proceeding, or convicted, fined or imprisoned for the violation of any law (exclude minor traffic violations)? [Please Select]YESNO
If yes, give full particulars of each case in an attached statement.
c) Do you have now or have you had contact with any member of any Government Security or Intelligence Service in the last three years? [Please Select]YESNO
If yes, provide details:
d) Have you ever been refused security clearance from any Government or security clearance agency? [Please Select]YESNO
If yes, for what position?
e) As far as you are aware, do you have or have you ever had any personal, professional connection or affiliation with:
Any of the parties to a situation/investigation or case pending before the International Criminal Court? [Please Select]YESNO
Any person working for the Court? [Please Select]YESNO
If you have answered yes to any part of this question, please provide full particulars in a separate statement.
DECLARATION
29.  To the best of your knowledge, do you have any personal or professional connection or affiliation with:
a)  Any of the parties to a situation pending before the International Criminal Court? YES NO
b)  Any person working for the Court? YES NO
If you have answered “yes” to any part of this question, please provide full particulars below:
I certify that the statements made by me in answer to the foregoing questions are true, complete and correct to the best of my knowledge and belief. I understand that any misrepresentation or material omission made on this form or other document requested by the Court may lead to immediate termination of the internship. I hereby confirm that I have read and accepted the Common Rules and Conditions governing the Internship and Visiting Professional Programme.
SIGNATURE: : ______DATE: : ______
ADDITIONAL DOCUMENTS TO BE SUBMITTED WITH THIS APPLICATION FORM
Applicants are required to submit copies of documents to support their application – full details of these requirements can be found on the website. The checklist below is to assist you with the compilation of your submission.
Please do not do not submit the originals of documents unless they have been obtained for the sole use of the Court. Incomplete applications will not be considered.
Two (2) references (one academic) / A short essay (two pages, single spaced, type written)
Copies of university degrees and/or diplomas / Optionally - recognised English/French language proficiency certificates (including score reports where applicable)
A concise written statement – motivation/benefits (max 400 words)
A transcript of courses taken during university studies
All documents should be in English or in French. If official documents, such as university degrees or transcripts, are not available in English or French, the candidate is requested to provide a complete and accurate uncertified translation into either English or French together with copies of the document. Applicant’s may be asked to provide a certified translation if appropriate.

All applications and documents should be sent to the following e-mail address:

.

Alternatively, the material may be sent by regular mail to the address indicated below. However, in this case, they must be received by the application deadline.

International Criminal Court

Internship and Visiting Professionals Programme

Post Office Box 19519

2500 CM The Hague

The Netherlands

Applications can also be sent by facsimile to the following number +31 (0)70 515 8558.

Kindly note that you only need to send your application by one of the means listed above.