international-nuclear-safeguards-internship-and-course-application

INTENSIVE COURSE ON NUCLEAR SAFEGUARDS POLICY AND SUMMER NUCLEAR SAFEGUARDS INTERNSHIP Application Form Please fill out completely and submit by email to Dr.. Pacific Daylight Time on

INTENSIVE COURSE ON NUCLEAR SAFEGUARDS POLICY AND

SUMMER NUCLEAR SAFEGUARDS INTERNSHIP

Application Form

Please fill out completely and submit by email to

Dr George Moore at gmoore@miis.edu by

5:00 p.m (Pacific Daylight Time) on Friday, March 6, 2020

Learn more:

https://www.nonproliferation.org/education/courses/international-nuclear-safeguards/

Please check one:

 I am applying for the intensive course on nuclear safeguards ONLY

I am applying for the intensive course on nuclear safeguards AND a nuclear safeguards internship

I took the intensive course previously and am applying for a nuclear safeguards internship ONLY

Applicant Information

Please type in Word document if possible

Current Contact Information

Last Name

First Name

Gender

(male, female, other)

Year of Birth

Current Street Address

City, State, Zip

Phone Number

Email Address

City, State, Zip

U.S citizen?  Yes  No

Green Card?  Yes  No

Country(ies) of

Citizenship other than the

U.S.

Permanent Contact Information

Permanent Street Address

City, State, Zip

Phone Number

Permanent Email Address

Educational Information

Undergraduate College or

University

Degree Status?  Graduated  Graduate Student Upper Division Undergraduate Student

Degree Program

Specialization or Major

fields

Graduation Date

GPA

Graduate College or

University

Degree Status?  Graduated  Graduate Student

Degree Program

Specialization or Major

fields

Graduation Date

GPA

Your affiliation at the

moment of application

Job Title

Organization

Student

University/College

Other

Please list your training and/or experience in nonproliferation or international security

Research Assistant:

Internships:

Government:

Private Sector:

NGO:

Other:

500 Word personal statement

Please attach, as a Word document, a statement which incorporates past

experience in nonproliferation issues as well as both your short and long term educational and career goals, and how this internship and/or intensive course will help you reach those goals

Please append the following:

Transcript (official or unofficial)

500 Word personal statement

One letter of recommendation

Resumé

Statement of needs for stipend support

Please note that incomplete applications will NOT

be considered.

By submitting this application, I understand that it is for consideration for

admission to the summer internship program and one-week intensive course in nuclear safeguards Completion of this form does not guarantee my participation

in these programs I further attest that all the statements on this application are true and correct to the best of my knowledge

Name

Date Submitted

Please submit this document to gmoore@miis.edu Supplemental application materials may be turned in to Dr George Moore in hard copy at the CNS Main office located at 499 Van Buren Street, Monterey, CA 93940