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NORWAY TRAINEE REGISTRATION FORM

Personal Information

Asmeninė informacija

 

Family Name: ____________________________    First Name:__________________________

Pavardė                                                                        Vardas

 

Date of Birth: ____________________________     Nationality: __________________________

Gimimo data                                                                Tautybe

           

Sex:                 Male       Female                     Religion:____________________________

Lytis:                Vyras               Moteris                         Religija

 

Current address:
Adresas

_______________________________________________________________________________

 

_______________________________________    Current tel: __________________________

                                                                                  Telefonas

 

Current e-mail: __________________________________________________________________

El. paštas

 

Passport number:_________________________

Paso numeris

 

Who should we contact in case of emergency:

Su kuo turėtume susisiekti nenumatytu skubios pagalbos atveju:

 

Name: _______________________________                     Phone number:_______________________

Vardas, Pavardė                                                                       Telefono numeris

 

Do you smoke?           yes      no            Are you allergic to anything ?  _______________________

Ar rūkote?                     Taip           Ne               Ar esate kam nors alergiškas?

 

Which category of driving licence do you have (if any)?

Kokios kategorijos vairuotojo pažymėjimą turite (jei turite)

A          B          C          D          E          T          Other:________________________

                                                                                                       Kita

 

How often do you drive: 

Kaip dažnai važinejate:

 

Every day        4 or more times a week         once a week                less than once a week

Kasdien                   4 ar daugiau kartu per savaite       Karta per savaite                 Mažiau nei kartą per savaitę

 

What kind of roads do you drive on:

Kokio tipo keliais važinėjate

 

City                  country                        highway                       Snowy/icy

Miesto                      Kaimo                                Greitkelio                           Snieguotas/Slidus

 

Have you ever had a driving accident:                        yes                  no

Ar kada nors buvote padares eismo ivykį:                         Taip                      Ne

 

Have you ever been penalised for any driving offences:                    yes                  no

Ar kada nors esate baustas už kelių eismo taisyklių pažeidimą:                   Taip                      Ne

 

Education
Išsilavinimas

 

Name of University:_______________________________________________________________

Universiteto pavadinimas

 

Faculty: ________________________________________________________________________

Fakultetas

 

Year started: ____________________________     Year of graduation:____________________

Priėmimo metai                                                            Baigimo metai

 

Main subject(s) of your studies: _____________________________________________________

Pagrindiniai studijų krypties dalykai

 

_______________________________________________________________________________

 

 

Please list university level coursework in agriculture/horticulture that you have completed:

Surašykite visus dalykus, susijusius su žemės ūkiu/sodininkyste, kuriuos baigėte.

 

_______________________________________________________________________________

 

_______________________________________________________________________________

 

 

English skills (please circle the level that best describes your level)

Anglu kalbos igūdžiai (apibraukite variantą, kuris tiksliausiai apibūdina jūsų lygį.

 

Written:           Very good                                good                                       fair

Rašymas             Labai gerai                                    Gerai                                             Patentkinamai

                       

Spoken:           Very good                               good                                        fair

Kalbėjimas          Labai gerai                                    Gerai                                             Patentkinamai

                       

How many years have you studied English: ___________________________________________

Kiek metų mokėtės anglų kalbos?

 

Other languages spoken: _________________________________________________________

Kitos kalbos

 

 

Practical experience in agriculture

Praktika žemės ūkyje

 

Have you grown up on a farm       yes              no

Ar užaugote ūkyje?                               Taip                      Ne

 

Kind of farm:                             ___________________________________________

Ūkio tipas

                                              

Picking berries/fruit                     yes     no     

Uogų/vaisių rinkimas                             Taip            Ne

 

Length of experience:        ___________________________________________

            Praktikos trukmė

 

         Which berries/fruits:          ___________________________________________

Uogų/vaisių tipas

 

Harvesting vegetables                  yes     no     

Daržovių derliaus nuemimas                    Taip           Ne

 

Length of experience:        ___________________________________________

         Praktikos trukmė

                           

         Which vegetables:             ___________________________________________

Daržovių tipas

 

Driving the tractor                       yes     no     

Traktoriaus vairavimas                            Taip           Ne

 

Length of experience:        ___________________________________________

            Praktikos trukmė        

                                     

What type of tractor:         ___________________________________________

Traktoriaus tipas

 

Caring for farm animals               yes     no     

Rūpinimasis ūkio gyvuliais                    Taip           Ne

 

Length of experience:        ___________________________________________

Patirties trukmė

 

         Which animals:                 ___________________________________________

Gyvulių rušys

 

         Work tasks:                     ___________________________________________     

         Darbo užduotys

                   

Milking                                      yes     no     

Melžimas                                              Taip            Ne

 

Length of experience:        ___________________________________________

         Patirties trukmė

 

What kind of milking equipment:_______________________________________

            Melžimo įrangos tipas   

                  

Horticultural work                        yes     no     

Sodininkystės darbai                              Taip            Ne

 

Length of experience:        ___________________________________________

Patirties trukmė

 

         Which kind of plants:          ___________________________________________

Augalų rušys

 

Crop farming                             yes     no     

Kultūrinių augalų produkcija                   Taip          Ne

 

Length of experience:        ___________________________________________

Patirties trukmė

 

         Type of crop:                   ___________________________________________

Paselių tipas

 

         Machinery/equipment used:___________________________________________

Naudotos mašinos/iranga

                                               ___________________________________________

 

Forestry work                            yes     no     

Miškininkystės darbai                             Taip           Ne

 

Length of experience:        ___________________________________________

Patirties trukmė

 

         Work tasks:                     ___________________________________________

Darbo užduotys

                                               ___________________________________________

                                     

         Machinery/equipment used:___________________________________________

Naudotos mašinos/įranga

                                               ___________________________________________

 

Other machinery and equipment used                yes     no     

Kita naudota įranga                                                      Taip            Ne

 

Length of experience:        ___________________________________________

Patirties trukmė

 

         Type of machinery/equipment: ________________________________________

Naudotos mašinos/įranga

 

Please describe your practical experience within agricultural work:

Apibūdinkite savo darbo praktiką, susijusią su žemės ūkio darbais.

 

_______________________________________________________________________________

 

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What are some of your hobbies?

Kokie yra jusu pomegiai?

 

_______________________________________________________________________________

 

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Do you do any sports:            yes                  no

Ar sportuojate?                         Taip                       Ne

 

If yes, what kind of sports and how often: _____________________________________________

Jei taip, kokia jusu sporto šaka ir kaip dažnai sportuojate?

 

_______________________________________________________________________________

 

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What do you expect to gain from the program:

Ko tikitės igyti programos metu?

 

_______________________________________________________________________________

 

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What is your motivation to take part in the program:

Kokia yra Jūsų motyvacija dalyvauti programoje?

 

_______________________________________________________________________________

 

_______________________________________________________________________________

 

_______________________________________________________________________________

 

_______________________________________________________________________________

 

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What can you contribute with towards your stay:

Kuo dar galite prisidėti savo buvimo laikotarpiu?

 

_______________________________________________________________________________

 

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Have you been abroad as a trainee before (please circle)?                yes                  no

Ar buvote užsienyje kaip praktikantas ankščiau? Apibrėžkite.                    Taip                         Ne

 

If yes, where have you been________________________________________________________

Jei taip, iįvardinkite vietas, kuriose buvote.

 

How long_______________________________________________________________________

Praktikos trukmė

 

 

Do you have a Norwegian  registration number? (if yes, please write the number)

Ar turite Norvegijos registracijos numeri? Jei turite, parašykite jį.

 

_______________________________________________________________________________

 

 

Do you have any health conditions that will affect your stay in Norway?
Ar turite kokių nors sveikatos sutrikimų, kurie galėtu paveikti Jūsų buvimą Norvegijoje?

 

_______________________________________________________________________________

 

_______________________________________________________________________________

 

 

If you have any references, please attach them to your application.

Jeigu turite kokios nors papildomos informacijos, pridėkite ją prie anketos.

 

 

I hereby confirm that I have read and understood the information on page 1 and 4 regarding the Norway Trainee programme, and I will participate in all parts of the programme. I have personally filled out this registration section with the correct information about myself. I am aware of the regulations concerning working hours, salary and payment of taxes. I also confirm that I am healthy, willing and able to perform manual labour.

 

Aš patvirtinu, kad perskaičiau ir supratau informaciją, pateiktą 1-4 puslapiuose dėl Norvegijos stažuočių programos, ir sutinku dalyvauti visose programos dalyse. Aš asmeniškai užpildžiau šią registracijos formą, pateikdama(s) teisingą informaciją apie save. Esu informuotas apie nuostatus, susijusius su darbo valandomis, darbo užmokesčiu ir mokesčių mokėjimu. Taip pat patvirtinu, kad esu sveikas, norintis ir sugebantis atlikti fizinį darbą asmuo.

 

Date and signature of the participant: __________________________________________

Data ir dalyvio parašas. (pildoma ofise)

 

We hereby confirm that this person is a student studying subjects relevant to agriculture. We also confirm that this person participates in the training programme is of relevance to his/her present studies at the university/school.

 

Mes patvirtiname, kad šis asmuo yra studentas, kurio studijų programa yra susijusi su žemės ūkiu. Mes taip pat patvirtiname, kad šio asmens dalyvavimas mokymo programoje yra aktualus jo / jos dabartinėms studijoms universitete / mokykloje

 

Name of university        :____________________________         Stamp of university:

Universiteto pavadinimas                                                                        Uninersiteto antspaudas

 

 

Name of partner:          ____________________________

Partnerio vardas

 

 

Date and signature of officer in charge: _____________________________________________

Data ir atsakingo asmens parašas.