PHOTO

Internship Application form

Fill in the shaded fields. Use the TAB key on the keyboard or your mouse to move between fields.

Instructions: Completed application forms should be accompanied by personal statement, curriculum vitae, and
letters of recommendation.

Type of Internship

Graduate Internship NYSC1 SIWES2/ Industrial Attachment Others (Please Specify)

1. PERSONAL DETAILS
Surname Gender: M F
Given name(s)
Nationality: Date of birth: YYYY/MM/DD
Correspondence
address: City State Country Postal code
Email Telephone Cellular

Permanent
address: City State Postal code
Next of Kin: Name Relationship Telephone
Address

2. EDUCATION AND EXPERIENCE

Institution Period of study (MM/YYYY) Major field of Degree obtained
(name and country) From To study

Area of specialization

Why do you wish to have your work experience in IITA?

Work Experience Institution Period(MM/YY)

From To

Internship Duration: Expected Start Date: YYYY/MM/DD Expected End Date: YYYY/MM/DD

3. LANGUAGE SKILLS
Mother tongue
Language Read Speak Write
Skills

Easily

Easily

Easily
easily

easily

easily
Not

Not

Not

English:
French:
Portuguese
Other language(s) (please specify)

Signature of applicant: Date: YYYY/MM/DD

1
National Youth Service Corp (NYSC): An internship program by the Nigerian Government for Nigerian graduates.
2
Student Industrial Work Experience Scheme (SIWES): Mandatory hands-on trainings for students in Nigerian higher institutions.