“challenges AND SOLUTION IN ASEAN URBANIZATION”

APPLICATION FORM

Thank you for your interest in HYLI!

Each year we strive to bring together the region’s sharpest students to discuss the important issues facing Asia and the world, and provide an opportunity to meet with the prominent figures from government, business, academia and NGOs.

Interested? Please read the points below carefully and tick the boxes accordingly. Applicants who are unable to fulfill all of the criteria or perform the roles stated below are not eligible to participate in the program.

Basic qualifying criteria

Students interested in applying for the 14th HYLI must:

Be a full-time undergraduate or graduate student at local universities approached

by Hitachi

Will remain as a full-time undergraduate or graduate student until completion of

HYLI program in July 2017

Maintain a minimum CGPA / CAP / GPA of 3.0 out of 4 (or 3.5 out of 5)

Be active in extra-curricular activities and / or community work

Have a keen interest in and be familiar with regional and global affairs

Have good written and spoken English, preferably with a flair for public speaking

Commitment to attend post HYLI event in each country scheduled from October to

December in 2017

Commitment to share the lessons learned in HYLI with as many peers as possible

Thrive to spearhead realization of sustainable and inclusive society as a leader

Graduates of past HYLI programs are not eligible to apply

Did you tick all the boxes?

Congratulations, you are eligible for consideration to be a representative of your country at the 14th HYLI!

Important notes

  1. The 14th Hitachi Young Leaders Initiative (HYLI) will be held from 10 to 13 July 2017 in Yangon, Myanmar.
  2. The final selection interviews are planned to be conducted from February to March 2017. Short-listed students must be available to attend their final interview.
  3. Students selected to participate in the 14th HYLI will be required to submit a paper on their research and understanding of their designated theme, prior to the event.
  4. Students selected will be requested to present a performance during the 14th HYLI that is representative of their home country’s culture.
  5. Students selected will act as ambassadors of their respective countries and will be required to respect the guidelines set out by the organiser and participate in all activities throughout the 14th HYLI.
  6. The organiser will sponsor event-related round trip airfare, hotel accommodation and meals of selected student representatives attending the 14th HYLI.
  7. For information on past initiatives, please visit:
  8. Please note that late submissions or incomplete application forms will not be considered.

-End of Note-

Participant Application Form

A.PERSONAL PARTICULARS

Name

Nationality

Country of Birth

Age Gender

Mailing Address

Home/Mobile Telephone

Email

B. EDUCATIONAL INFORMATION

Please attach photocopies of results for all university level examinations.

Institution Currently Attending

Faculty

Subjects Majored in

Current Year of Study (e.g. First year, Second year)

Grade Point Average (GPA / CGPA / CAP)

Educational Background

Schools/Institutions and Country Attended / Highest Standard Passed / Year Passed

Other Academic Qualifications

C.COMMAND OF ENGLISH LANGUAGE

TOEIC/TOEFL score (if applicable)

Written (Please state level of proficiency: excellent, good, fair)

Spoken (Please state level of proficiency: excellent, good, fair)

D. EXTRACURRICULAR ACTIVITIES

a. Societies/Clubs/Sports

Name of Organization / Description of Involvement
[e.g. level of participation(State if member or officer), prizes and awards where applicable) / Period of
Membership / Person In Charge
/ Contact Details

b. Participation in non-university sponsored young leaders program

Name of Organization / Description of Program / Period of
Participation / Person In Charge
/ Contact Details

c. Scholarships and Other Activities

(e.g. Community and voluntary work, debates, essay/art competitions, scouts etc.)

d. Hobbies/Interests

E. ESSAY

Please answer the following questions:

  1. Why do you want to join the Hitachi Young Leaders Initiative (HYLI)?

What difference will HYLI make in helping you achieve your goals?

(Please limit your response to 250 words)

  1. Nowadays, we have been witnessing various societal issues arise from rapid urbanization in ASEAN countries. What challenges does your country currently face on urbanization most seriously? What is being done to address them? What would you do differently? (Please limit your response to 500 words)

Before you tackle on the essay, please study the Sustainable Development Goals (SDGs) by United Nations so that you can understand international agenda related to urbanization.

F. REFERENCE

Please obtain the signature from one university official as a referee who supports your participation in the initiative. Please note that relatives and friends should not be used as referees and the organizer may contact the referee(s) for a testimony if necessary.

Name

Occupation Company/Organization

Office/Mobile Number Email

Relationship to Applicant

I, ______hereby affirm that the applicant of this application form fulfills the basic qualifying criteria to apply for the program and I recommend the applicant’s participation in the initiative.

______

Reference’s Name and Signature Date

Basic qualifying criteria (Please check the criteria the applicant fulfills)

Be a full-time undergraduate or graduate student at local universities approached

by Hitachi

Will remain as a full-time undergraduate or graduate student until completion of

HYLI program in July 2017

Maintain a minimum CGPA / CAP / GPA of 3.0 out of 4 (or 3.5 out of 5)

Be active in extra-curricular activities and / or community work

Have a keen interest in and be familiar with regional and global affairs

Have good written and spoken English, preferably with a flair for public speaking

Commitment to attend post HYLI event in each country scheduled from October to

December in 2017

Commitment to share the lessons learned in HYLI with as many peers as possible

Thrive to spearhead realization of sustainable and inclusive society as a leader

Graduates of past HYLI programs are not eligible to apply

G.DECLARATION
  1. I hereby affirm that the information provided in this application form is true and accurate to the best of my knowledge.
  1. I hereby agree and consent that Hitachi, Ltd. and Hitachi Asia Ltd. (“Companies”) may collect, use, disclose and process my personal data which is provided by me in this application form or otherwise, for one or more of the purposes relating to the Companies’ “14th Hitachi Young Leaders Initiative” (“Project”), which in summary includes but are not limited to the following:
  1. The screening of my application for the purpose of selectionfor this Project;
  1. In the event that I am offered to be a student delegate to the Project and have agreed to such offer, for the following purposes:
  2. Arrangement of meals, accommodation and transport for attendance to the Project including collection of passport information, medical conditions and dietary restrictions (where applicable);
  3. Public disclosure of my name, university affiliation, and nationality to promote the Project. Public disclosure includes but is not limited to Companies website, news release, Project white paper and other print and online publications;
  4. Public disclosure of my interview responses to media representatives attending the Project; and
  5. Maintaining contact with the Companies as member of the exclusive Hitachi Young Leaders Initiative alumni network post-Project;
  1. The purposes stated in Hitachi Asia Privacy Terms and Conditions available at

(collectively, the “Purposes”)

  1. My personal data may/will be disclosed by Companies to its third party service providers or agents (including public relations agency(ies)), which may be located within or outside of Singapore, for one or more of the Purposes and such third party service providers or agents, if engaged by Companies, would be processing my personal data for Companies for one or more of the Purposes.
  1. To the extent that Companies appoint any authorised public relations agency(ies) to collect, use, disclose and process my personal data for Companies for one or more of the Purposes, the consent given herein shall be extended to such collection, use, disclosure and processing of my personal data by Companies’ authorised public relation agency(ies).

I have read and agree to the above:

______

Applicant’s Name and Signature Date

1