Working Holiday Program - Applicant's details

Last update 27.01.2025

Fields marked with an asterisk (*) are mandatory.

Surname

Name

Emergency contact information:

Contact name

Address

Telephone No.

Secondary contact

Commune where you intend to register as your first residence in Luxembourg:

Do you intend to stay in Luxembourg during the whole period of the program? Yes No

If not, please clarify your intentions:

Details on your employment

Name of employer

Address

Proposed type of employment

Period of employment

Daily working hours

Disclaimer:
The collection of the data required by this form and any personal data will be supplied to the relevant authorities of the Grand Duchy of Luxembourg and processed by its authorities, for the purposes of the visa application.

The authority of the Member State responsible for processing the data is:

Ministère des Affaires Etrangères et européennes
Direction des affaires consulaires et des relations culturelles internationales
Bureau des Passeports, visas et légalisations
6 rue de l’Ancien Athénée
L-1144 Luxembourg
service.visas@mae.etat.lu

Contact details of the data protection officer: dpo.mae@cgpd.etat.lu

You have the right to receive information about the source, recipients, and purposes of your archived personal data at any time without having to pay a fee for such disclosures. You also have the right to demand that your data are rectified or eradicated. If you have consented to data processing, you have the option to revoke this consent at any time, which shall affect all future data processing.
Moreover, you have the right to demand that the processing of your data be restricted under certain circumstances. Furthermore, you have the right to log a complaint with the competent supervising agency.

The national supervisory authority of the Grand Duchy of Luxembourg will hear claims concerning the protection of personal data:
Commission Nationale pour la Protection des données
1 avenue du Rock'n'Roll
L-4361 Esch-sur-Alzette
https://cnpd.public.lu/fr/support/contact.html
https://cnpd.public.lu/fr.html

The information contained in this application form may be confidential or protected by applicable laws and in particular Regulation (EU) 2016/679 on the protection of individuals with regard to the processing of personal data and on the free movement of data. They are for the attention of the recipients only. If you are not the primary recipient, nor one of the relevant authorities, disclosure, copying,
distribution or any other use of this paper is prohibited and may be unlawful. In this case, you must notify the Directorate of consular affairs and international cultural relations immediately and destroy this paper.