aman peace school 2012 - application form

8/3/2019 AMAN Peace School 2012 - Application Form

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7th SCHOOL OF PEACE STUDIES & CONFLICTTRANSFORMATION

February18 March 10, 2012Penang, MALAYSIA

Bangkok and Pattani, THAILAND

Application Instructions

Who can apply

Peace and development workers from NGOs and faith based organizations,peace and human rights activists, youth leaders, researchers, journalists, youngscholars and development professionals who are active in peace studies orpeace building programs.

Preference is shown for applicants who can demonstrate how this course will

directly benefit their organization or academic institution in developing or peaceprograms at local, regional and/or international level.

Proficiency in English is required. If you are accepted you will be required toparticipate in academic lectures, discussions and role plays in English. Pleasedo not apply if you do not have strong English skills.

Previous course participants are not eligible to apply.

How to apply

By 5 December 2011, send completed application form, resume/CV, statementon Peace, two letters of recommendations and passport photo to:

International Institute of Peace Studies c/o Asian Muslim Action NetworkHouse 1562/113, Soi 1/1Mooban Pibul, Pracharaj Road,Bangkok 10800, ThailandTel: 66-2-9130196Fax No.: 66-2-9130197E-mail: [email protected]

This form may be submitted by fax or e-mail.

Applications will be acknowledged on receipt. Applicants will be notified of theoutcome of selection soon after the closing date.

No application or request for financial support will be considered until all

application materials are complete.

Registration and Course FeeCourse fee is $ 200 US (food, accommodation, transportation within Thailand andMalaysia and international travel between the two countries, materials and training feewill be offered to the successful candidates). Participants are responsible for round-triptravel cost from home country to Penang, Malaysia and from Bangkok, Thailand to homecountry. Participants are expected to seek financial support from their organization andother foundations.
mailto:[email protected]:[email protected]


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APPLICATION CLOSE DATE: 5 December 2011


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Application Form

Please do not include any information that you think might affect your safety andsecurity

I - PERSONAL INFORMATION1. Family Name: 2. Middle Name:

3. First Name: 4. Nick Name / name you want to be called:

5. Male / Female: 6. Date of Birth:

7. Age: 8. Place of Birth:

9. What religious tradition (if any) do you identify with?

10. Do you identify as an Indigenous person / member of an ethnic minority? Y/NIf yes, please specify.

II CONTACT DETAILS11. Postal Address - Number/Street:

12. City: 13. State/Province:

14. Country: 15. Postal Code:

16. Phone Number 1: (including country code):

17. Phone Number 2: (including country code):

18. Fax number: (including country code):

19. Email Address:

20. Alternative email address:

III PASSPORT DETAILS21. Passport Number: 22. Citizenship:

23. Country of Birth: 24. Country Issuing Passport:

25. Issue Date: 26. Expiration Date:

IV - ORGANIZATIONAL INFORMATION & WORK EXPERIENCE27. Name of organization / cause you work for:

28. Current Position (include specific job responsibilities):


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29. Write a short summary of your role and otherpractical experience you have hadregarding peace issues / concerns:

30. Outline the reasons why you would like to participate in the 6th School of Peace Studiesand Conflict Transformation. Please explain how this course relates specifically to your

work or situation and how you might apply the learnings from the course in your work in thefuture.

31. Please briefly describe a project, campaign or issue on which you are working on or haveworked on that you think is relevant to this program and that you will be willing to shareinformation about with other participants during the program.

V EDUCATIONAL BACKGROUND32. Degrees / courses successfully completed: (Please list all colleges, universities, and

professional schools attended, beginning with most recent. Include degrees or certificatesearned, dates attended.) Please attach CV or Resume.

33. Other training, including previous PEACE training: (Please give details)

VI - LANGUAGEIf you are accepted you will be required to participate in academic lectures, discussionsand role plays in English. Please do not apply if you do not have strong English skills.

34. Is English your mother tongue?

YES ( ) or NO ( )If your mother tongue is notEnglish, please answer all the following questions as fully as

possible.

35. How have you learnt English?

36. How often do you use English and where do you use it?

37. Rate your English ability using the scale: 1=fair, 2=good, 3=excellent

Spoken English: ______ Written English: _______ Comprehension: _________

VII - REFERENCE LETTERS ( Enclosed or Sent separately )Please include 2 letters of recommendation from your referees.One reference should be from the head of your organization or immediate work supervisor.Letters should be a maximum of one page in length. Please ask your references to addressthe following questions:

1) What is the role of the applicant in their organization?2) Will the applicants participation in this program impact positively on his/her work?3) Why do you feel this candidate will benefit from School of Peace Studies and Conflict


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Transformation program?4) Please confirm English proficiency of applicant.5) Please include any other information you think is relevant.

Reference 1 (details)

Name:

Organization:

Relationship:

Email:

Fax(including country / district area codes):

Phone (including country / district area codes):

AMAN Affiliation (if any):

Reference 2 (details)

Name:

Organization:

Relationship:

Email:

Fax(including country / district area codes):

Phone (including country / district area codes):

AMAN Affiliation (if any):

38. How did you hear about this training?

VIII - SPONSORSHIP

You will need to consider whom to approach to sponsor yourtravel expensesandthe coursefee of $ 200 US (which subsidizes food, accommodation, materials and training fee).

39. Do you have funding for your course fee and travel expenses?

40. AMAN will sponsor a limited number of applicants for this program. Would you like to beconsidered for sponsorship? (if yes, please give reason for need) :

41. Travel Cost: Round trip travel costs from my city of residence to Bangkok, Thailand isapproximately ___________? (Please give figures in US dollars formost affordable fare)

IX - TRAVEL INSURANCE

All participants must have their own travel insurance for both Thailand and Malaysia. The costof medical care in Bangkok and Malaysia is extremely expensive. In the past we have had

participants who have been sick and have had to go to hospital; this has cost them more than

10,000 Thai Baht or 1,000 Malaysian Ringgit. If you do not have travel insurance then you are

not able to attend the program.

Name of Insurance Company:_______________Policy number:____________________

X - EMERGENCY CONTACT INFORMATION


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Name

Relationship

Mailing Address

Tel./Fax

E-mail

Occupation

Position

Organization

XI - CONSENT42. Do you give us consent to use the information provided in this form to write a shortbiographical paragraph about you that will be given to trainers, participants and others for thepurposes of informing them, seeking funding on your behalf, advertising this training and infuture School of Peace Studies publicity material?

YES NO

43. Do you have concerns about your personal security that we should consider before usingthe information you have provided here?

YES NO

XII - WRITTEN STATEMENT44. Please write a statement on Peace and diversity in your local area or country,highlighting yourknowledge of local peace and conflict issues. The statement should alsoanswer:- Where do you see the biggest challenges in promoting peace in your community/country?

- Where do you see the greatest opportunities for promoting peace in your community/country?(one to two typed single pages, maximum 1000 words)

Essay is Enclosed or Sent separately

XIII - SIGNATURE AND PHOTOGRAPH

45. I certify that the information I have provided on this application form and in any attachedmaterials is true and complete.

Full signature ________________________________ Date: __________________


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Date completed: _________________

APPLICATION CHECKLIST

Before submitting the application, please make sure you have included:___ Passport photo___ Two letters of reference___ Statement on peace and diversity___ Curriculum vitae or resume___ Proof of travel health insurance___ Signature and date

Incomplete applications will not be considered.

Please attach

passport

photograph

aman peace school 2012 - application form

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