giz Participant Declaration Form/Teilnahmeerkiérung | wish to lake part in the Triple Win program and accept the belowsnentioned conditions. ich mochte an dom Programm Tripke Win teiinehmon und akzeptiors die nachtolgend genannten Teiinahmebedingungen. ‘Sumame/Name, First name/Vomame. HILARION . bm SRNOrA Date of pith/Geburtsdatum ie- 0G - 14a ‘AddressiAdresse BkG7. wire, KULAN cor ORR Telephone number Telefonnummer #65466 Yo? 29° “Erma Wailea rant larione Gra. Coon Place/Ort, NULen, SULTAN un mepe Date/Datum, Pdi CU IORS, ‘Oetebee 2001 Poge?giz Participant Declaration Form for the Triple Win program = Information and conditions for program participants ~ The Federal Employment Agency's International Placement Services (ZAV) and the Deutsche Geselischaft fir Intemationale Zusammenarbeit (GIZ) GmbH are jointly implementing the Triple Win program, which aims to balance the interests of foreign skiled workers, their Countries of origin and the German labour market. The program is conducted on the basis of bilateral placement agreements between the Federal Employment Agency and the state ‘employment agencies of Bosnia and Herzegovina, the Philippines, Indonesia, and Tunisia, {i order to participate in the Triple Win program, you must have completed nursing taining in your own country and meet the health requirements for commencing work in Germany. You eed to be prepared for the challenges of the German language and specific aspects of German nursing training, in order to find work and succeed in Germany's nursing sector, it is ‘essential fo have the foundational linguistic and professional skis. ‘The program offers you linguistic and professional preparation in Bosnia and Herzegovina, the Philippines, Indonesia and Tunisia. This process continues in the form of further support with integration and skils recognition in Germany. We also assist you with organisational matters ‘such as completing visa formalities and making arrangements for your outward joumey from your home country to Germany. You can safeguard your skils in the long term by having your professional qualifications recognised in Germany and integrating successfully in the country. Participation in the Triple Win program is free of charge to you, as your German employer will ‘cover the cost of all the services provided to you as part of the program. You are required to ‘cover the costs for visa and obtaining required documents. Preparatory and support measures and terms and conditions of participation To participate in the preparatory and support measures of the Triple Win program, you must: (1) pass the selection interview with the staff of ZAV's Triple Win program and (2) read and ‘sign this Participant Declaration Form. 1. As a participant inthe Triple Win program, you will bonoft from the following preparatory ‘and support measures: + assessment of your German-language proficiency (upon admission to the program); * participation in language training up to the Goethe-Insiitut’s B1 certificate level or, alternatively, a certificate recognised by the German embassy in your own country in accordance with the embassy's requirements; , ‘+ specialist preparation in your own country: a (four-day) preparatory course dealing with hands-on issues for working in Germany (overview of differences in training systems; general nursing: geriatric care; hospital structure; hygiene: recognition process; legislation); ‘(one to two days of) orientation training: information on ‘working and living in Germany’ will be integrated into the courses; ‘* support for and coordination of your departure process; ‘+ assistance with your visa application at the German embassy, ‘© ‘support for coordinating arrangements for your mave to Germany with your employer, Poge 2giz + our Integration Advisor in Germany will assist you and your employer with the integration process (provision of advice to employer in conjunction with a workshop, for instance on Fecognition procedures) and you! will be provided with an information kit. 2. Benefits for the participants + Bonus allowance for successfully passing the A2 and 81 exam with the first attempt of 250€ each. ** Financial support for the costs for transiation and notarization of documents needed for the Tecognition application in Germany, + Financial support for medical checks, i required. Including the mandatory measles vaccination needed to work in German health facilities, f applicable. 3. B1 language test and certificate of participation Following regular attendance of the language course and after passing the examination, you wil be awarded the B1 cortiicate of the Goothe-Institut (or, altematively, a certificate recognised by the German embassy in your cwn country in accordance with the embassy’s requirements). You will also receive a certficate of participation after successfully completing ‘the professional preparatory course. 4. Terms and conditions of participation 8) Regular participation in the preparatory courses and support measures On signing the Participant Declaration Form, you undertake to participate regularly in ‘the preparatory courses throughout the entire program tarm in accordance with the ‘ules and provisions of the Triple Win program in your own country. ») Participation in the language course: ‘You undertake to attend the language course regularly (atleast 80 par cent of classes). {f you are absent for more than 20 per cent of classes, then you will be excluded from the language course. ©) Bt certificate * You are required to obtain the B1 ceriificate from the Goethe-Institut ora certificate that is accepted by the Triple Win program in coordination with the ‘German embassy in your own country) and the certificate of participation in the professional preparatory course in order to obtain a visa for travelling to Germany lo work for a German employer. '* The goal for all participants is to pass the 81 certification exam within the program. The program will cover the costs for taking the B1 test forthe first time a8 well as your first re-take. You will shoulder/pay for the costs of all. ‘succeeding retakes, * You are given 3 months after the first retake to obtain your B1 Certificate. Exemption Pandemic situation: 6 months due to less exam’s availability. + For the retakes, a preparation training will be offered and paid by the program. Your Participation is mandatory. (October 2021 Page 3giz +The examinations for cbtaininy te BY vertficale are organised by the pragrarh in consultation with the language course institutions. All partisans undertake to attend the tests on the datas get by the prexram. + You are invited 16 take the test subject to priot apptoval Hort your instructor, This moans that you cannot decide arbitrarlly whother you are ready for the examinaiion. if you decide to take the test without your instructors recommendation, then you must bear the cost of examination yourset. In this ‘case, you must inform the Triple Win program in your own country before siting ‘tho oxaminaticn. + you have alteady boon admitted to the program with a BH coricate, than you are required to take a proficiency teat. K your proficiency test score indicates @ {ow level of knowladge, then you will be required to attend a language course ‘atthe program's expense, You wil also be required to re-take andl pass the 81 examination f your submitted 81 certificate is older than one year at the time of your outward journey. @) Monitoring “Your individual progress in leaming the German language is evaluated. The program ‘and the language schoo! joinly monitor the progress of all course participants, if you {allo meet the criteria for moving up to the next level of language course, then the Janguage schoo! is entitled to keep you at this save level in order for you to repeat the Hearing content. 2) Cost reimbursement by participants who discontinue the preparatory measures I at any point during the program, you decide to discontinue your participation or ere removed for significant reasons for which you are responsible then you are required to ‘eienburse GIZ tor its contribution to the costs of your participation in the preparatory, and support measures. GIZ may grant exceptions to this obligation to pay, where ‘payment would amount to undue hardship. itis up to the program to decide whether there are sufficient grounds or good reason for your discontinuition of the preparatory measure. 1) Travelling to. Germany ‘You as a participant travelling to Germany undertake to + provide the evidence of a sufficient command of the German tanguage (B1 ‘examination certficata) required for the issuing of a visa: = Obtain and submit all the documents necessary for the issuing of visa in their required form {translated and, where relevant, officially certified) and attend ‘necessary in-person appointments al the German embassyithe German consulate; - complete and send all applicationsforms tequired for the recognition of professional skills, and submit the required documents at your own expense to the ‘responsible body in the requisite form (officially certiied and transiated — with apostle); = travel fo Germany promptly, in consultation with your employer. after your visa has. been issued and you have been granted a work permit recognising your suitability, to take up employment as nurse. ‘5. Exclusivity agroomont Pages:giz ing this Participant Dectaration Form, you undertake for a one-year period, starting with Geet of tua er to refrain from entering into a contract of employment with an employer that was not arranged within the scope of the Triple Win program. # you do enter into such a ‘contract, then you wil Be required to reimburse GW for the costs it has incurred in payments owans your particination in praparminry and eupport mansirme, 6, Applicable law and place ot jurisdiction ‘shail be: the taw. in the Federal ot The Ageert sha be prema ya ew alee Republic of Germany.