APPLICATION FOR ADMISSION

Deadline for application: 19April 2017

Please send the completed soft copy form to Daw Thin Aung Htoo at:

(or)

Please send the completed hard copy form to U Aye Kyu at:

Mandalay British Council office - 30 Street, Bet 77 & 78 Streets | Mandalay

Type or write in BLOCK LETTERS

  1. Personal Information

Family Name:
First Name:
Date of Birth (day/month/year): / Place of Birth:
Gender: / Male Female
Place of Birth (City/Country):
Citizenship:
Passport number:
Address for correspondence:
Telephone (
Home):
Telephone (Work):
Telephone (Mobile):
E-mail address:
Name, telephone (home, work, mobile), address, e-mail of person to be notified in case of emergency:

2.Academic Background and Language Skills
Academic Background
(Please specify the following data)

Type of Degree / Field of study / Institution / City, Country / Starting date –
end date (month/year)
Ability / Speaking / Writing / Reading / Listening
Myanmar / / Fluent / / Fluent / / Fluent / / Fluent
/ Good / / Good / / Good / / Good
/ Satisfactory / / Satisfactory / / Satisfactory / / Satisfactory
English / / Fluent / / Fluent / / Fluent / / Fluent
/ Good / / Good / / Good / / Good
/ Satisfactory / / Satisfactory / / Satisfactory / / Satisfactory

3. Employment Details

3.1 Please describe briefly your current & past occupation for the past 2 years

3.2 Please list any work experience, whether paid or voluntary, in the field of Film, Human Rights and/or Advocacy. List the most recent experiences first.
Human Rights

Title / Institution / City, Country / Starting date – end date (month/year)

Film(or related)

Title / Institution / City, Country / Starting date – end date (month/year)

Advocacy

Title / Institution / City, Country / Starting date – end date (month/year)
4. Motivation Letter (Max. 300 words)
Explain why you wish to attend this course, what are your expectations, what would be your contributions to the course?
5. Idea for a Film of Video Project (Max 300 words)
Please describe an idea for a film or video project, or of an ongoing project on issues related to human rights and advocacy that you would like to develop during this course.
6. Please submit 1 or 2 examples of your recent work
This may included produced films, video, or any other form of visual art production.

Applicant’s Signature Date

1