APPLICATION FORM
FOR SETTING UP THE POOL OF ASSESSORS
PUBLISHED IN THE FRAME OF HU-SRB IPA CBC PROGRAMME
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I. PERSONAL INFORMATION
I.1.General information
Name: ......
Date of birth:......
Address of permanent residence: ......
Mailing address (if different as permanent residence):
......
Mobile phone, e-mail:......
Workplace: ......
Address: ......
Telephone, fax: ......
I. 2.Education and training (please add as many tables as necessary)
University/ Institution (name, town):Dates (from-to):
Principal subjects/ Qualification:
Degree/ Certificate obtained:
University/ Institution (name, town):
Dates (from - to):
Principal subjects/ Qualification:
Degree/ certificate obtained:
University/ Institution (name, town):
Dates (from - to):
Principal subjects/ Qualification:
Degree/ Certificate obtained:
I.3.Professional experience (please add as many tables as necessary)
Dates (from - to):Name of employer and position:
Main responsibilities:
Dates (from - to):
Name of employer and position:
Main responsibilities:
Dates (from - to):
Name of employer and position:
Main responsibilities:
- FIELDS OF EXPERTISE
Please indicate the major area and the domain you are interested in performing assessor activities.(More fields can be marked though in the end the assessor selected will not necessarily be contracted for all the marked fields.)
Fields of expertise / Years of experience1.1 Infrastructure for physical connections
Border crossing infrastructure
Construction, reconstruction of lead-up roads
Planning of transport lines, harmonisation of public transport
Other: …………………………………………………………. / 5-10 years
10-15 years
More than 15 years
1.2 Common responsibility for the environment
Minor actions in water management
Minor actions for improving the quality of the environment
Animal health monitoring
Other: …………………………………………………………. / 5-10 years
10-15 years
More than 15 years
2.1 Stimulating a synergic economy, tourism and R&D
Trainings and partner finding facilitation for businesses
Development of thematic routes of cultural heritage
Coordinated studies for territorial and sectoral development of the region
Product oriented research, development and innovation
Other: …………………………………………………………. / 5-10 years
10-15 years
More than 15 years
2.2 Education and culture for a common mind
Educational co-operation
People to people co-operation
Other: …………………………………………………………. / 5-10 years
10-15 years
More than 15 years
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III. WORK EXPERIENCE
III.1a) Work experience in the field of programme management and finance or project cycle management
I do posses
I don’t posses
III.1b) Other experience
management of EU projects
technical and economic feasibility studies
preparation of cost-benefit analyses, financial plans
environmental assessments
preparation of technical, construction documentation
project evaluation
other (please list) ……..………………………………………………………………..
III.1c) IT literacy
I do posses
I don’t posses
III.1d) Language skills
Proficientor native user of Hungarian language
Proficient or native user of Serbianlanguage
Fluency in English language
III.2.Please describe your experience/knowledge/competence related to domestic and/or EU funds(please add as many lines as necessary)
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......
......
III.3. Description of the special fields of expertise/ expert workindicating special competencies in the fields indicated in the section II. Fields of expertise(please add as many lines as necessary)
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......
......
III.4.Please list the publications in areas concerned by the Programme you have elaborated individually or in a collective of authors (please add as many lines as necessary)
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III.5.Please present your knowledge regarding the target area of the Programme, i.e. the border region/counties between Hungary and Serbia and your experiences about the planning and/or strategic development documents, strategies on regional, county or local level (please add as many lines as necessary)
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III.5a)Have you ever participated as assessor in project evaluation? If yes, please listthe performed tasks and give data regarding the evaluation(e.g.: name of the programme or funding source,contracting authority, type of evaluated projects, field of interventions, etc.) (please add as many lines as necessary)
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III.5b)If you have ever worked as assessorfor the National Development Agency or VATI in Hungary or for the Ministry of FinanceofSerbia please indicate in the table below.
Contractor / Date of assignment (year) / Reference number and name of the call for proposals (if not specified, name of the Programme (grant source) and measures/activity fields concerned) / Number of evaluated projects / Grant size(Euro per project)
III.6)Membership in professional bodies, functions(please add as many lines as necessary)
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Ihereby assume responsibility for the information provided in this Application and by my signature I acknowledge that I have read and understood the Call for Assessors and concerned documents.
Date:......
……………………………………………………..
Signature
ANNEXES:
- Curriculum Vitae (in the Europass format–
- Copies of the diploma(s), certificates (e.g. degree, trainings, language, etc.)
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