Application biocamp 2011
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The document appears to be an application form for the Novartis Biotechnology Leadership Camp (BioCamp) in 2011. It requests personal details, educational background, professional experience, additional information on academic awards, career experiences, interest in Novartis careers, how the applicant expects to benefit from BioCamp, language skills, other skills/interests, and references. It notes the deadline for applications is June 20, 2011 and selected students will be informed by July 7, 2011. Applicants are asked to email a scanned copy of the completed form to the provided email address.
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Application biocamp 2011
- 1. BioCamp 2011 NOVARTIS BIOTECHNOLOGY LEADERSHIP CAMP Application Form 1. Personal data Family Name: First Name:______________________________ Mailing Address:____________________________________________________________________________ ___________________________________________________________________________________________ Phone:______________________________Mobile:________________________________________________ E-mail: _______________________________________________________ Date of birth: Nationality: Gender Male Female________________ 2. Educational background Accomplished studies by May 31, 2011: Bachelor Master Doctoral Post-Doctoral Academic and educational record: Institution Subject Degree Date attended Tick the right (mm/yyyy) percentile class below _______________________________________ _______________ _______________ _____________ 5%, 10%, 15%, Other _______________________________________ _______________ _______________ _____________ 5%, 10%, 15%, Other _______________________________________ _______________ _______________ _____________ 5%, 10%, 15%, Other _______________________________________ _______________ _______________ _____________ 5%, 10%, 15%, Other 3. Professional experience Employer Job title Date of employment (mm/yyyy) _______________________________ _____________________________ _______________________ _______________________________ _____________________________ _______________________ _______________________________ _____________________________ _______________________ 4. Additional Information a. List significant academic awards ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ b. List any significant professional or career related experiences ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ c. Have you attended other leadership camps or related programmes? If yes, give name of programme, name of institute conducting programme and year ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ d. Would you be interested in a career with Novartis and if yes, what is your area of interest and how soon would you be available for employment? ___________________________________________________________________________________ ___________________________________________________________________________________
- 2. e. How do you expect to benefit from BioCamp? Include any information you think is relevant to your application (do not exceed space provided here) __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ 5. Language skills 6. Other skills & interests Language Proficiency ____________________ _____________________ ____________________________________ ____________________ _____________________ ____________________________________ ____________________ _____________________ ____________________________________ 7. References 1. Name Institution/Company Job Title Contact No./Email __________________________________________________________________________________________________________________ 2. Name Institution/Company Job Title Contact No./Email __________________________________________________________________________________________________________________ 8. How did you hear about BioCamp? Internet Campus Poster Family/Friends Faculty Member Other (please specify) Please ensure that your application form is endorsed here by your current Academic Institute with name & signature of Head of Institute, date and stamp. Institute Name: __________________________ Signed by Institute Head, date & stamp: ____________ Deadline for applications is June 20, 2011. Selected students will be informed via e- mail by July 7, 2011. Email scanned copy of completed form to biocamp.india@novartis.com Only completed applications will be considered.