Application Forms and Attachments Should Be Submitted by Email, to CIFAL Jeju Office At

 Application forms and attachments should be submitted by email, to CIFAL Jeju Office at y Sunday 9 March 2014 (with “20142ndCCA & DRR Workshop Application” in the subject line) or fax them to +82-64-738-4626.

Participant Name
(Please type your name in capital lettersas written in your passport.) / Title / Mr/Ms/Mrs/Dr/Others (please specify)
Surname
Middle name
First name
Position
Gender (M/F) / Date of Birth (yyyy/mm/dd)
Nationality
Postal Address
(Office Address) / PO Box
Street
City
Postcode
Country
Contact Information
(Country code + Regional code + Phone/Fax number) / E-mail
Office Phone
Mobile Phone
Fax
Organizational Affiliation
(Choose one. Please specify the name of your organization in the space provided.) / Academia
Government – National
Government – Local
Government – State
International Organization(nonUN)
NGO
Other
Private Sector
Regional Organization
UN/UN System
UN/UN System
(locally recruited)
Describe your work
Reference(Please provide the name and address of your supervisor/the head of your organization/government.)
Name / Position / Contact details
Are you sponsored by your organisation/government or from any other sourcesfor your airfare, accommodation and other travel costs? (please specify) / Yes ( ) No ( )
How did you learn about the event?
(Choose all that apply.) / By mailed or faxed announcement
By email
By social networking (Facebook, Twitter, etc.)
By word of mouth
By local press
Other
English Skills / Ability to Understand / Good( ) Fair( ) Poor( )
Ability to speak fluently / Good( ) Fair( ) Poor( )
Ability to read / Good( ) Fair( ) Poor( )
Ability to write / Good( ) Fair( ) Poor( )
English Proficiency Test / TOEIC ( )
TOFLE ( )
IELTS ( )
Others ( )
Questionnaire
Needs Assessment for “Developing Capacities on Climate Change Adaptation (CCA) and
Disaster Risk Reduction (DRR) in the Asia-Pacific Region”
※Please describe in your own words (maximum 250 words).

1. Are you familiar with the concepts of 'Climate Change Adaptation (CCA)’ and ‘Disaster Risk Reduction (DRR)’? If so, do you have any idea how to apply these concepts to your local context?

1. Does your country or city/municipality have an action plan or strategy for climate change adaptation and disaster risk reduction?

1. What are the common climate change related disasters or risks you face in your city/municipality or territory? And how do you commonly deal with these? (Give one example of a recent incident.)

1. Is your government engaged in any regional/international activities to address issues related to climate change and disaster risk?

1. Has your organization initiated activities to promote effective climate change adaptation and disaster risk reduction?

1. Describe the three key challenges for your government in effectively preparing for natural disasters and mitigating risks from climate change.

1)
2)
3)

1. How do you intend to follow-up with the action plans you will present at the training workshop?

County Information(maximum 2 pages in MS Word Format)
Please briefly write the situation of your country in terms of climate change adaptation and disaster risk reduction, including the information of which international conventions your country is party to, responsible national and regional organization, and policies.
Have you participated in a previous CIFAL event? / Yes No / (If yes, please specify)
Please write why you want to participate in this workshop and how your job is related to climate change adaptation and disaster risk reduction

Please attach:

1. A Curriculum Vitae(maximum 2 pages)

2. Country Information(maximum 2 pages)

3. Letter of Nomination

4. Letter of Commitment

 Applications without the above attachments will not be accepted.

For general information please contact:

CIFAL Jeju

227-24, Jungmoongwangwang Road,

SeogwipoCity, Jeju, Republic of Korea

Phone: +82 (0)64 735 6581

Fax: +82 (0)64 738 4626

Email:

Letter of Nomination

OrganizationName: ______

Nominates the following person (name): ______

to participate in the CIFAL Jeju Workshop, and certifies that:

___ All information supplied by the nominee is complete and correct;

___ The nominee has adequate knowledge of the working language of the training programme (English);

___ The nominee, if selected, will participate actively and conscientiously in all the training activities provided by CIFAL Jeju.

Applicant’s Immediate Supervisor (Name): ______

(Position): ______

Office Telephone Number:______

E-mail Address:______

______

(Signature)(Date)

Letter of COMMITMENT

All parts of the above application form are true and verifiable. If I am selected to participate in the CIFAL Jeju Workshop, I will attend all its training activities, actively pursuing my project objectives and completing any assignments given related to the training programme. I am aware that I have to submit a country information and, once selected, learn and apply the Making Cities Resilient (MCR) Tools, Diagnosis and Assessment and make City Action Plan during the workshop.

______

(Printed Name)

______

(Signature)

______

(Date)

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