Annex II:RC ADRIA Internship Programme – An

Application Form for RIS Task Partners

The Faculty of Mining, Geology and Petroleum Engineering of the University of Zagreb (RGNF), the Geological Survey of Slovenia (GEOZS) and the Institute of Civil Engineering of Slovenia (ZAG) respect your privacy and oblige to carefully protect personal data obtained through the application procedure in accordance with the law. We will use and store your personal information solely for the purpose for which we collected the personal information, that is, until you withdraw your consent. By using appropriate technical and organizational procedures to protect your personal information, we will prevent any unauthorized access or release of your personal information.

Instructions: Please replace the instructions written in red with a required and accurate data. Each cell has to be filled in order to consider your application. Please have in mind that the information which you provide here will have to be confirmed by an appropriate evidence within the application process!

PROJECT DETAILS

Project name: EIT RM HUB – REGIONAL CENTER ADRIA

Lead Partner: GeoZS

RIS Task Partner Patron: UNIZG-RGNF

APPLICANT DETAILS

Legal name: Please insert the official name of your organization.

Type of organisation: Please choose the type of your organization (ony ONE).

☐ University (academic and/or research in raw materials)☐ Research institute / organization active in raw

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materials☐ Industry representative / company active in raw materials☐ Association / Chamber relevant for the raw materials sector☐ Other stakeholder contributing to the raw materials sector.

Legal address: Please insert the official address of your organization.

VAT number: Please insert the VAT number (tax) of your organization.

Legally responsible person:

Please insert the name and function of the legally responsible person in your organization (e.g. John Smith, director)..

Contact person: Please insert the name of the person we can regularly contact in your organization.

Contact person e-mail address:

Please insert the e-mail address of the contact person.

Contact person phone number:

Please insert the phone number of the contact person (including the country code).

APPLICANT EXPERTISE

Please answer YES or NO to the following statements regarding your expertise.At least 3 expertise areas should be selected (each question covers one field of expertise).

My organisation is the owner of raw materials data and provider at regional / country level (e.g. geological data, mining properties inventory data, secondary deposits inventory data, etc.).

Instructions: Please answer YES or NO and if YES - specify data type.

My organisation possesses sound knowledge of the following areas in the raw materials sector and can utilize this knowledge for the purposes of the project.

Instructions: Please tick areas relevant for your organisation ☐ YES, local regulations and legislation☐ YES, local policy☐ YES, policy analysis ☐ YES, legal analysis☐ YES, economic analysis

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APPLICANT EXPERTISE

☐ YES, multi factor analysis☐ YES, local regulations for intellectual properties ☐ NO, not in the scope of my organisation

My organisation is able to manage local raw materials sampling, sample handling and processing for use in the project.

Instructions: Please tick areas relevant for your organisation ☐ YES, local raw materials sampling☐ YES, sample handling☐ YES, sample processing☐ NO, not in the scope of my organisation

My organisation can carry out accredited measurement and analysis for the locally taken raw materials samples for use in the project.

Instructions: Please answer YES or NO and if YES - specify.

My organisation is the owner or has access to certain local raw materials sites / test sites or materials/processes and will provide access to these sites to the project.

Instructions: Please tick areas relevant for your organisation ☐ YES, access to local raw materials sites ☐ YES, access to local test sites☐ YES, access to materials☐ YES, access to processes☐ NO, not in the scope of my organisation

My organisation is able to perform industrial tests as owner or producer of a certain technology and to participate in measurement and validation activities in the project.

Instructions: Please answer YES or NO and if YES - specify.

My organisation is able to carry out research and development (R&D) activities in the field of raw materials and to conduct R&D or utilise R&D results for the project.

Instructions: Please answer YES or NO and if YES - specify.

My organisation is a member of or affiliated with major raw materials networks (i.e. chambers or professional associations) in its country of origin.

Instructions: Please answer YES or NO and if YES - specify.

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INTERNSHIP EXPECTATIONS

Preferred number of interns:

Please select ONE option.☐ Our organization can receive only one (1) Intern in 2020.☐ Our organization can receive up to two (2) interns in 2020.☐ Our organization can receive up to three (3) interns in 2020.

Required computer skills (software):

Please list all professionally relevant software in which you expect the interns to independently carry out simple tasks and operations (e.g. Microsoft Office, AutoCAD, ArcGIS, ArcMap, GEOrient etc.).

Preferred duration of the internship:

Please select ONE option referring to the desired duration of the Interns’ stay in your company☐ 1 month☐ 2 months☐ 3 months☐ All options are acceptable.

Preferred time of year in which the Internship could be carried out:

Please select most suitable options regarding the time of year when the internship in your company can take place (multiple answers are possible).☐ March – May 2020☐ May – August 2020☐ August – October 2020☐ October – December 2020.

Other possible preferences

Please inform us if there are any other preferences regarding the Internship which are not covered by the previous questions.

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REQUIRED FUNDING

YEAR REQUIRED FUNDING

Clarification

2020 500,00 Euro

Each selected RIS Task Partners which will sign the Collaboration Agreement with UNIZG-RGNF, thus formally accepting at least one student for an Internship in the minimum duration of one month and up to three months will receive a one-time funding of 500 €. This lump sum is covering time for training course and supervising time.

☐ I understand that the information provided in this form has to be substantiated by evidence and herby confirm that, to my best knowledge, all the information provided by me is true.

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