1Instructions2General Information3Internship Goals4Post-Primary Education5Employment and Experiences6Language and Skills7Citizenship Information8Hobbies9Additional Information10Documents11Signature KTH INTERNSHIP PLACEMENT PROGRAM; Work to learn and give in Palestine! INTERN/VOLUNTEER APPLICATION The KTH Internship Placement Program is designed to match skilled and passionate individuals with a compatible Palestinian organization in need, whether that be KTH or a number of other initiatives in the region. We believe that each individual passionate for Palestine has a unique role to play in its development. We help you realize this role and connect you where you will be most effective. INSTRUCTIONS FOR COMPLETION: Incomplete applications will not be considered. You must submit a 1-page-maximum signed cover letter with your application which answers the following important questions. Why do you want an internship in Palestine through KTH? What goals are you expecting to achieve personally and for Palestinians collectively through the KTH Internship Placement program? What occupation interests you and why? Are there specific professional skills or experience do you hope to gain through a KTH Internship Placement? What personal gifts or unique perspectives will YOU personally bring to the organization you are placed with, whether KTH or another initiative? How will you give back that organization and to its mission through your specific skill set and passions? Are you a KTH Alumni? If so, please state the year you traveled with the program and how your KTH experience influenced you to apply to this program. You must submit a 1-page resume or CV with your application. If applicable, this should include your work history of the last 3 positions or more. 2 letters of recommendation from professors, academic advisors, supervisors, coaches, or other adult mentors, MUST be submitted in order for your application to be considered complete. the two (2) letters of recommendation must be signed (physical signature) by those recommending you. Letters should be sent via email to kth@hcef.org as scanned PDF attachments. The letters should be on letterhead and include the recommender’s title and complete contact information. Recommendation letters must be sent to kth@hcef.org from the organizational/company e-mail of the person recommending you. Each letter must be addressed to “The KTH Internship Placement Committee” Do not exceed the space provided for each response. If you require additional space, please use the additional page at the end of your application. You must submit 1 profile photo of yourself electronically. Your application must be signed (actual signature) by you. APPLICANT GENERAL INFORMATIONFull Name* Title Mr.Mrs.MissMs.Dr.Prof.Rev. First Middle Last Social Security # Your date of BirthMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Home Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email address Enter Email Confirm Email APPLICANT’S INTERNSHIP GOALS Internships typically last for a minimum of 10 weeks, and a maximum of 1 year.What is the earliest date you can begin your internship?Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920What is the latest date you can complete your internship?Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920What is the ideal length of time you would like to spend at your internship? *Please note that due to the political situation in the occupied Palestinian Territories, entry into the country and visa renewal is up to the state of Israel. There is very little we can do as an organization to guarantee the state of Israel will grant you re-entry for your internship. APPLICANT’S POST-PRIMARY EDUCATION (most recent first)1)School NameCompletion levelMajorGPAGPA in major (optional):Coursework in your field of interest2)School NameCompletion levelMajorGPAGPA in major (optional):Coursework in your field of interest3)School NameCompletion levelMajorGPAGPA in major (optional):Coursework in your field of interest APPLICANT’S EMPLOYMENT/VOLUNTEER EXPERIENCE & LEADERSHIP1) Organization or group name Begin Date of involvementMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920End Date of involvementMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Please briefly describe your responsibilities and specific projectsindividually or as part of a team2) Organization or group name Begin Date of involvementMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920End Date of involvementMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Please briefly describe your responsibilities and specific projectsindividually or as part of a team3) Organization or group name Begin Date of involvementMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920End Date of involvementMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Please briefly describe your responsibilities and specific projectsindividually or as part of a team LANGUAGE AND SKILLSPlease note Arabic proficiency is NOT a prerequisite.Place a number in the box next to your self-assessed level in each skill (Listening comprehension, speaking, reading & writing) for each language which you understand, speak, read and/or write. Thank you for your complete honesty Skill Level Descriptions (1) Beginner: Understands/can say a few polite words or phrases. (2) Intermediate: Can understand basic topics/express oneself intelligibly, even if slowly, with some pauses or with lapses into ones first language. (3) Proficient: Understands most words in native conversation or text/can express oneself correctly and eloquently on a wide variety of topics, and does NOT require word-for-word translation to learn new vocabulary or concepts. In each language you add, please fill the fields next to it by choosing one of the following only: (1) Beginner, (2) Intermediate, (3) ProficientLanguageSpeakingListeningReadingWriting In each language you add, please fill the fields next to it by choosing one of the following only: (1) Beginner, (2) Intermediate, (3) ProficientCommentsSPECIAL SKILLS OR KNOWLEDGEPlease select a box for each of the special skills or knowledge that apply to you. Accounting Advocacy Arabic-English Interpretation/Translation Architecture/Engineering Art: (painting, animation, music, drama, creative writing, etc.) Banking Bi/Multilingual (English/etc. Business/ Business Administration Chef/Cook Communications/Broadcasting/Journalism Construction Education Event Management/Coordination Finance Fundraising/Proposal Writing Graphic Design IT/Software Development Law Marketing Medicine/Nursing Natural Sciences Photography/Videography Psychology/Sociology/Social Work/ Counseling Research Web Design/Management Other CITIZENSHIP INFORMATIONCitizenship(s) Passport #List for each country of citizenship Do you have the Palestinian I.D. (huwīya/ بطاقة هوية)?* Yes No What is your full name? Please write the four names that appear on your ID If you have an active Palestinian I.D., you may not be able to participate in the KTH Internship Placement Program due to current political restrictions outside our control. Please fill in above the four names that appear on your I.D. and your I.D. number. With this information we will attempt to confirm whether or not you are eligible to travel to Palestine. APPLICANT’S SPORTS, HOBBIESPlease list any sports, hobbies and personal interests. ADDITIONAL INFORMATIONPlease describe any previous visits to and/or your familiarity with Palestine. Please include the dates of any previous visits.How did you hear about Know Thy Heritage and this internship placement program? If you are a KTH Alumni, please note the year you traveled and how your experience influenced your decision to apply.If you heard from a personal friend or relative, please provide his or her name.If applicable, what is your family’s history in relation to Palestine? Please briefly describe your family’s past in Palestine and any events since leaving Palestine which you feel are significant.If possible please use full names of relatives you mention.Additional Comments UPLOAD YOUR FILESPlease upload a recent photo for yourself*Max. file size: 30 MB.Please upload your CV*Max. file size: 30 MB.Please upload your Cover Letter*Max. file size: 30 MB. APPLICANT SIGNATURE In signing this application I certify that all of the information included is true and accurate. I have answered all of the questions truthfully and to the best of my ability. Signature of ApplicantApplicants may be contacted by the KTH Internship Placement Committee for more information or to set up an interview. You will be notified if you are approved for a specific internship position through the KTH Internship Placement Program. Upon placement, additional forms, guidelines, and contracts must be submitted in order to secure your internship position. KTH staff will do their best to match your application to the ideal position. KTH cannot guarantee an internship position. Thank you for your interest!! Δ