APUCEN INTERNATIONAL YOUTH
VOLUNTEER AWARD
Application Form
2017
Administered by:
Asia Pacific University-Community Engagement Network (APUCEN) Secretariat
Division of Industry and Community Network
Level 1, Building E42, Chancellory II,
Universiti Sains Malaysia,
11800 USM Penang,
Malaysia
+604-653 6419
APUCEN INTERNATIONAL YOUTH VOLUNTEER AWARD
OBJECTIVES
1. To increase awareness of the importance of volunteerism and community care among students and youth (balancing knowledge and character of the next generation).
2. To honor, recognize and acknowledge active student volunteers who are committed to sustainable community engagement activities.
3. To encourage teamwork and cooperation among students and youth.
ELIGIBILITY
1. Open to all students in universities registered as APUCEN members.
2. Teams must be nominated with endorsement from institution supervisor/coordinator.
3. Projects nominated must be no less than 18 months and ongoing.
4. Teams must have a minimum of 3 students. (Age from 18 to 35 years old)
IMPORTANT SUBMISSION REQUIREMENTS
1. All applications must be submitted on the APUCEN International Youth Volunteer application form.
2. Only fully completed application forms will be accepted. All sections must be completed. Incomplete application will not be considered for the award.
3. Attachments/supporting documentation (photographs, letters, etc.) are required.
4. The deadline for submission to the APUCEN Secretariat is Thursday, March 30, 2017.
5. Applications should be submitted by email at:
6. Scanned copies of supporting documents are acceptable.
7. Should you have any further enquiries, feel free to contact us at +604 653 6419 or email us at .
8. If you are unable to submit your application electronically, please fax it to +604 -653 6406 or post it to
Asia Pacific University-Community Engagement Network (APUCEN)
Division of Industry and Community Network
Level 1, Building E42, Chancellory II,
Universiti Sains Malaysia,
11800 USM Penang,
Malaysia.
AWARD SELECTION
1. Award selection is based on the applicant’s volunteer efforts and commitment of time, accomplishments, community impact and enhancement of the lives of others, as described on the application form.
2. The selection panel will consider:
· the impact and sustainability of the project to the local community
· dedication and commitment demonstrated
· challenges faced by the volunteers
· benefit for the volunteer team and institution/organization
3. One CASH Prize Award for each category. All winners will receive a plaque and Certificate of Appreciation from APUCEN. Each award will involve a sponsorship of USD3,000 cash award.
APUCEN INTERNATIONAL YOUTH VOLUNTEER AWARD
APPLICATION FORM
Name of Institution: ______
SECTION 1 – BEST TEAM APPLICATION CATEGORIES
APUCEN MEMBER
Yes No
VOLUNTEER SERVICE CATEGORIES / Mark box that apply to the applicant’s service
Health Youth
Environment Entrepreneurship
Education Women
Open category for the public (Non APUCEN Members)
SECTION 2 – Applicant’s Information
Name of Institution ______
Project Leader’s Title Ms. Mrs. Mr. Dr. Other ______
Project Leader’s First Name ______
Project Leader’s Last Name______
Address ______
City ______ State ______Zip ______
Phone _______
Email Address ______
Designation ______
NOTE: The contact person listed above will accept the award on behalf of team.
TEAM MEMBERS
Name ______
Identification Card Number ______
Age ______
Name ______
Identification Card Number ______
Age ______
Name ______
Identification Card Number ______
Age ______
Note : Additional Members can be named as attachment
Please attach summary curriculum vitae of each team member
SECTION 3 – Nominator and Reference Information
IMPORTANT REQUIREMENTS FOR THIS PAGE
1. Institution supervisor/coordinator must sign the page.
2. Forms without the required signatures will not be accepted.
INSTITUTION SUPERVISOR/COORDINATOR
Name______Address______
______
City ______State ______Zip ______
Phone ______Email Address ______
Authorized Signature and ______Date ______
Rubber Stamp
SECTION 4 –Project Information
Project must be no less than 18 months and ongoing.
PROJECT
SECTION 5 – Details of the Project
· Objectives/Aims of the project
· Approach of the project
· Impacts and Benefit
· How this projects can be sustainable
· What are the challenges faced by the volunteers?
(Maximum 1000 words)
SECTION 6 – MEDIA AND OTHER INFO
For further information,you maycontact us , call us at +604-653 6419or log on to our website atwww.apucen.usm.my
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