The Wine & Law Program – A Jean Monnet Chair

WINE & LAW IN THE EUROPEAN UNION

8th School

«CYBER WINE»: LEGAL ISSUES OF THE WINE SECTOR IN THE DIGITAL ERA

October15– 19, 2018

Application Form

Available to download at

Please read these guidelines carefully. Failure to follow them may result in suspending your application from the selection process.

  1. Type and provide allrequested information in English.
  2. All sections of the application must be completed.
  1. Application Materials
  • Completed Application Form
  • Curriculum Vitae (CV) in English (with a recent passport-size photograph)

Please return the completed application form with full documentation to:

Mrs. Monique DESSALLES,

Your application together with your CV must be received no later thanSeptember 7, 2018(after this date a full registration fee applies).Applications received will only be considered if places are still available.

Pleasedo not send any documents (diplomas, certificates, etc.). Only successful applicants will be asked to send copies of such documents and will receive instructions on enrolment procedure and tuition-fee payment.

All documentation should clearly indicate the applicant’s name and contact address.

1. Name

family name first name middle initial

  1. Date and Place of Birth:
  1. Nationality & Passport or ID Number :
  1. Permanent Address

Street and number

City, Postcode Country

Telephone number:

Fax number:

E-mail:

  1. Education

Please list all post-secondary education (university or equivalent) in reverse chronological order:

Institution/Country / Degree obtained / Duration
from/until / Grade
  1. Employment

Please list all relevant work experience in reverse chronological order (internships and volunteer experience should be included):

Employer / Position / Country / Duration
from/until
  1. Language Proficiency

1. Which is your mother tongue?:

2. Please indicate your proficiency level in English and in any other language you use as “excellent”, “very good”, “good” or “satisfactory”.

Language / Reading / Speaking / Writing
English

For non-native English speakers,in case of acceptance to the Summer School, proof of their proficiency in English should be provided upon request (TOEFL scores, degrees from English-speaking establishments, publication records, working experience..).

  1. Motivation

Please answer the following question, within the space provided. DO NOT attachadditional sheets.

Why do you want to participate in Wine & Law in the European Union – Summer School ?

______

  1. General Information

You learnt about theTheUniversity of Reims Wine & Law in the European Unionthrough:

  • the brochure
  • the Internet
  • Advertisement
  • Colleagues
  • Other______
  1. Personal Choices on the Program:

1. Do you want wish to pass the final examination in order to obtain the Diploma of Wine & Law in the EU of the University of Reims?

Yes No, I prefer obtain the Certificate of Attendance

2. If yes, do you have any disabilities requiring special treatment?

Non Yes

If Yes, please specify:

  1. Verification of Authenticity

By signing below I attest that, to the best of my knowledge, all information provided in this application and its supporting documentation is true and accurate. I understand that misrepresentation in these documents may cause the disqualification of my application.

______

Signature Date (dd/mm/yyyy)

CONSENT

By signing this consent form, I confirm that pursuant to the provisions of the European General Data ProtectionRegulation (GDPR), Mrs Moniques Dessalles, with her registered establishment at the Law School of Reims, BP 30, 57, rue Pierre Taittinger, Reims, 51571, cedex, France, as a data controller, may process my personal data given above for the purposes of communication and information on the future activities of the Wine & Law Program – A Jean Monnet Chair.

The consent is provided for an unlimited period until it is revoked. The personal data may be modified or supplemented, and the consent to processing thereof may be revoked by sending an e-mail to . In such a case, the provided personal data will be updated, blocked or deleted, according to the relevant request. Receiving electronic mails or messages of any kind may be revoked in the same manner at any time.

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