<p> APPLICATION FORM</p><p>STUDY APPRENTICE IN NT CATTLE STATION</p><p>AUSTRALIA - 2013 FORM NO : ...... </p><p>PERSONAL DATA A Full Name : Nick Name : Place, Date of , : Birth - - Religion : Sex : Male Female Marital Status : married Single Father Name : </p><p>Mother Name : Address : </p><p>Province : City : Post Code : Telephone : - Mobile : - Fax : - Email : </p><p>Occupation : SMA / D1 D2 D3 S1 S2 S3 Last Education : SMK </p><p>EDUCATION INFORMATION B</p><p>STUDY INSTITUTION YEAR IN YEAR OUT (SD/RA) * (SPM/MTS) * (SMA/SMK/MA) * ...... * ) Circle accordance Options</p><p>ORGANIZATION DATA C</p><p>ORGANIZATION NAME POSITION YEAR IN YEAR OUT COMMITTE EXPERIENCE IN CBC D</p><p>COMMITTE POSITION YEAR</p><p>TRAINING / SEMINAR / WORKSHOP E</p><p>TRAINING NAME ORGANIZER SCALE YEAR</p><p>LANGUAGE SKILL F</p><p>LANGUAGE SPEAKING READING WRITING LISTENING SCORE PLEASE ANSWER THIS QUESTION BY YOUR SELF ! G Answer this question with clearly and maximum 50 words per question!</p><p>1. please explain about your personality!</p><p>2. Do you have a problem with your healty for joining this program? </p><p>3. If your answer is YES, please explain to us!</p><p>4. Do you have a problem with your family for joining this program? 5. If your answer is YES, please explain to us!</p><p>6.</p><p>7. What do you know about this program?</p><p>8. What do you know about cattle industry relation between Indonesia and Australia?</p><p>9. What will you do to increase Indonesian cattle industry with this program?</p><p>10. Why we must choosing you?</p><p>11.</p><p>12. If you have chosen to be a participant for this program, what would you do to this program and to your organization?</p><p>13. Are you ready to pay accomodation and training cost in Indonesia, if there’s no help from the sponsors? 14. Please explain about your ambition after you finished to participated this program on this one short pharagraph on this coloum !</p><p>STUDY APPRENTICE THEME PLANE H Please explain what is your theme plane for your study apprentice report. You can find information about NT cattle station work in the Internet or your friends who got work experience in there. This will help you to preparing your study apprentice on this program.</p><p>I declare the details stated to be true and complete..</p><p>Your Newest ...... , ..... - ...... - 20 .... Picture With Colour 3 X 4 cm</p><p>( ...... )</p><p>Animal Husbandry Faculty – Universitas Padjadjaran Jl. Raya Jatinangor Sumedang Km.21 Jatinangor Sumedang - 45363 Telp/Fax: (022) 7798241/ (022) 7798212 www.cattleandbuffaloclub.blogspot.com [email protected]</p>