Annex II

Instructions: Candidates who wish to be considered as seconded should submit their application forms to their respective national authorities for their approval. All applications sent directly to EEAS-EUSR-HR@eeas.europa.eu will be considered. Please fill in completely the application electronically and send it in the original format, i.e. MS Word 2003.

Application deadline is January 15, 2013

Application form for Secondment- Political Adviser to the EUSR on Human Rights

(to be sent by e-mail to EEAS-EUSR-HR@eeas.europa.eu)

1. NOMINATION DETAILS Post no/title Political Adviser to the EUSR on Human Rights 2. PERSONAL DATA Last name First name Birth date (dd/mm/yyyy) Country of birth Passport no. Gender Male Female Present nationality Other nationality Security clearance Yes No X If yes, at what level: Driving license Yes X No If yes, category: 3. CONTACT DETAILS Home country address Street Zip/postal Code Town/city County/state/province Country Telephone no. Mobile no. Email address 4. EDUCATION AND PROFESSIONAL TRAINING University education or equivalent Attended (mm/yyyy) Name institution / university, place and country Degrees/qualifications obtained (Title of qualification awarded) Main course/field of study From: To: Secondary education and/or formal vocational education/training Name institution / place and country Degrees/qualifications obtained (Title of qualification awarded) Main course/field of study From: To:

5. EMPLOYMENT RECORD (in reverse chronological order)

Current/most recent position	Current position: Yes No
Organisation	Place and country	Job title	Date (mm/yyyy)
From:	To:
Description of tasks and responsibilities (management level, supervisory level, number of personnel supervised):
Supervisor’s name:	Email:	Phone No.:
Previous position (1) (only positions longer than 6 months)
Organisation	Place and country	Job title	Date (mm/yyyy)
From:	To:
Description of tasks and responsibilities (management level, supervisory level, number of personnel supervised):
Supervisor’s name:	Email:	Phone No.:
Previous position (2) (only positions longer than 6 months)
Organisation	Place and country	Job title	Date (mm/yyyy)
From:	To:
Description of tasks and responsibilities (management level, supervisory level, number of personnel supervised):
Supervisor’s name:	Email:	Phone No.:
Previous position (3) (only positions longer than 6 months)
Organisation	Place and country	Job title	Date (mm/yyyy)
From:	To:
Description of tasks and responsibilities (management level, supervisory level, number of personnel supervised):
Supervisor’s name:	Email:	Phone No.:
Other previous positions and positions shorter than 6 months
Organisation	Place and country	Job title	Date (mm/yyyy)
From:	To:

6. OTHER SKILLS

Languages (European level *)	Native language:
Other languages	Speak	Write	Read	Understand

C1, C2 = Proficient; B1, B2 = Independent User; A1, A2 = Basic User

(*) Common European Framework of References for Languages

Computer skills
Word processor	Web browsing	Presentations
Spreadsheets	Financial software	Project management

C = Proficient User; B = Independent User; A = Basic User; N/A

7. MOTIVATION AND ADDITIONAL INFORMATION

Please explain the reasons for your application, covering your profile and particular interest in this position. Add any other information that might be relevant to your application, including any skills, knowledge and experience for which there was no space above.

8. FINAL QUESTIONS

Please read and answer carefully all questions
Do you have any objections to our making enquires of your employers?	Yes No
Do you have any chronic health problems, disabilities or other medical conditions that would limit your physical activity?	Yes No
Are you regularly taking any medication?	Yes No
Is any relative of yours, to the best of your knowledge, working in (Name of the Mission)	Yes No
Is any relative of yours, to the best of your knowledge, applying to this Call for Contributions?	Yes No
Have you ever been convicted or sentenced in any criminal proceedings (excluding minor traffic violations)?	Yes No
If you responded “yes” to any of the previous questions, please provide details
By submitting this application form, I certify that the statements made by me in answer to the foregoing questions are true, complete and correct to the best of my knowledge and belief. I understand that any misrepresentation or material omission made on the Application Form will result in the application being void and will result in termination or dismissal from the mission	I agree: Yes No
Place	Date	Signature (typed name is sufficient)

If selected under contracted status, you will be requested to supply documentary evidence which supports the statements you made above. Do not, however, send any documentary evidence until you have been asked to do so.

Please submit the completed form as a MS Word Document no later than January 15, 2013