XXX (d/f/m) - note: 1. Use a personal job title (not a generic term like “Clerk”) 2. Include (f/m/d) 3. Specify the field or department if necessary, do not use abbreviations such as MTA, BTA, etc.

Salutation *

Title

First name *

Last name *

E-mail *

Phone number

Do you have a disability or equality? *

Wie sind Sie auf uns aufmerksam geworden? *

Who recruited you and from which area / ward does the person who recruited you come from?

I would like to be a part of the Charité application ppol for 18 months and accept the use and processing of my data according to the privacy policy Datenschutzerklärung/-richtlinie section 3.2. I am aware, that I can revoke my consent in written form at any time.

I hereby accept the use and processing of the data supplied with my application according to the privacy policy Datenschutzerklärung/-richtlinie .

* Pflichtfeld

XXX (d/f/m) - note: 1. Use a personal job title (not a generic term like “Clerk”) 2. Include (f/m/d) 3. Specify the field or department if necessary, do not use abbreviations such as MTA, BTA, etc.

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