2) National ID Number: (Tazkira Number)*

/ Institutional Development for Energy in Afghanistan(IDEA)
Women’s Initiatives for Sustainable Energy (WISE)
APPLICATION FORM
Part A: Information about the Nominee
NOTE: it is required to fill in the designated * items as is shown below.

1)Full Name*

2) National ID Number: (Tazkira Number)*

3)Passport Information*

3.1) Name of Nominee

Last Name*

First Name*

Middle Name (if any)

Passport No.Issued at (province)

Issued DateExpiry Date

4) Information about the Nominee*

4.1) Nationality / Afghan -National / 4.2) Date of Birth*yyyy/MM/dd / Age
4.3) Sex* / Female

4.4) Occupation (if any)

Name of Entity/Organization
Department/Division
Position

4.5) Please describe your current responsibilities and daily rituals*

4.6) Contact Information*

Office / Address:
TEL: / Mobile No.
E-mail:
Home / Address:
TEL: / Mobile No.
E-mail:
Contact person in emergency / Name:
Relationship:
Address:
TEL: / Mobile No.
E-mail:

4.7) Language Proficiency*

Language to be used in the program: English
Listening / Excellent / Good / Fair / Poor
Speaking / Excellent / Good / Fair / Poor
Reading / Excellent / Good / Fair / Poor
Writing / Excellent / Good / Fair / Poor
Certificate (Examples: TOEFL, IELTS and etc.)
Native Language

4.8) Educational Record*

Institution / City/
Country / Period / Degree obtained / Major
From
Month/Year / To
Month/Year

4.9) Trainings

Institution / City/
Country / Period / Degree obtained
From
Month/Year / To
Month/Year

4.10) Career Record* (if any)

Organization / City/
Country / Period / Position or Title
From
Month/Year / To
Month/Year

4.11) Business Record* (if any)

Type of Business / Age of business / Own Investment / Loan finance
Why I started this business / What challenges I faced / Future Plans

4.12) If not started business, but planning to:

Business Idea / Why I wish to start this business / Approximate Investment
5) Please describe how this program will help you achieve your goals and long term commitments.
200 words

6)Declaration (to be printed and signed by the Nominee)*

I certify that the statements I made in this form are true and correct to the best of my knowledge.

If accepted for the program, I agree:

(a)To follow the program, and abide by the rules of the institution or establishment that implements the program,

(b)To refrain from engaging in political activity or any form that may harm the regulations of German Cooperation and Afghanistan Gov.

(c)To be present in all the classes and workshops during the training period on time and according to the schedule developed by the training provider,

(d)To develop a business plan and/or plan of action as instructed and moderated by the coach and meet the entire deadlines for preparation, presentations and assignments,

Date: / Name:
Signature: ______

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