Asia-Pacific Transitional Justice and Peace-building
Summer Institute in International Law and Human Rights
May 11-24, 2008
APPLICATION FORM
Please type or use block letters
Passport number ______Country of issue ______Expiration date
IMPORTANT:PLEASE PROVIDE COPY OF PASSPORT PAGE STATING NAME, BIRTHDATE, AND BIRTHCITY
Full name as stated in passport
female
______ male
(Title) Mr., Mrs., Ms., Dr. (first and other name)(FAMILY/SURNAME IN CAPITAL LETTERS)
Current position/job title ______
Institutional affiliation ______
Institutional mailing address ______
______
Business telephone ______Home telephone ______
Facsimile no. ______E-mail address ______
Nearest airport ______U.S. Social Security Number (if applicable)
Country of citizenship ______City and country of birth as shown on passport ____
Country of legal permanent residence ______Date of birth ______
(spell-out month) (day) (year)
Post-secondary education (Begin with most recent and include all degree courses and relevant short-term technical or professional training.)
Institution attended and language of instruction / Major subject / Dates / Degree completedRelevant work experience (Begin with most recent employment and include all current jobs. Attach additional information on a separatepage if necessary.)
Dates / Position/title / Employer / City/countryLanguage skillsPlease provide us with information regarding your languages skills, ranking your abilities from 1 to 4. 1 = Poor, 2 = Good, 3 = Very Good and 4 = Excellent. Please attach any evidence of English language proficiency to this application form.
Language / Is this your native language? / Reading / Writing / Speaking / ListeningDescribe your present duties and responsibilities, with specific emphasis on work related to your selected workshop-strand:
Have you participated in an East-WestCenter or OHRSSD activity before?
Activity: ______Program: ______Year: ______
List your publications (if any), particularly in fields relevant to the workshop. (If necessary, place on separate sheet.)
Title of publication / Date, where published1
List below any scholarships, fellowships, grants, contracts, or other awards you have received, including grants to attend international conferences, workshops, or seminars. Please specify which, if any, awards are current and indicate expiration dates.
One reference must be submitted in support of your application. Please list below the name of the referee you have selected. The reference should be received by 15 February 2008.
Name / Position/institution / Date you requested referenceI am applying to the following workshop strand: (Mark one only.)
Judicial Mechanisms and Truth Commissions
Human Rights Investigation, Documentation and Reporting
Peace-building and Conflict Resolution
Signature of applicant ______Date ______
Name and title of nominating official (usually a department head or immediate supervisor) (Please print.)
______
Signature of nominating official ______Date ______
The application deadline for Summer Institute 2008 was February 15, 2008. However, in exceptional circumstances, the Organizers are willing to consider applications submitted after this deadline. Please contact Michelle Staggs, Coordinator, at for further information.
Acceptance letters will be sent out in March 2008. Send the completed application by airmail directly to: Summer Institute 2008, Office of Human Rights Studies and Social Development, Faculty of Graduate Studies, Mahidol University, Salaya Campus, Salaya, Nakhon Pathom, Thailand, 73170 or by email to: Michelle Staggs, Coordinator, at .
Please be certain that the following materials are enclosed:
Application Form Funding and Housing Form
Workshop Statement Copy of passport inside front page
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WORKSHOP STATEMENT
(must be submitted with application form)
Name of applicant ______
Workshop applying for (mark one only):
Judicial Mechanisms and Truth Commissions
Human Rights Investigation, Documentation and Reporting
Peace-building and Conflict Resolution
Please describe your relevant education, research, and/or work experience and indicate how participation in the workshop will benefit your future work.
Use back and additional sheets if necessary. If you are using a word processor, you may place your entire statement on a separate sheet attached to this form.
______Signature of applicant ______Date
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FUNDING AND HOUSING FORM
(must be submitted with application form)
NOTE:
All applicants are expected to seek funding from their home organizations or governments or from outside funding agencies.
PLEASE TYPE OR PRINT CLEARLY
Name of applicant ______
□I will be self-funded.
□I will be funded by the following sponsoring agency:
Contact person/Title ______
Name of funding organization ______
Mailing address ______
______
Telephone ______Facsimile no. ______
E-mail address ______
□I am still seeking sponsorship and would like my application to be considered.
(Please immediately forward confirmation of funding to uponnotification from sponsor.)
□I have applied for funding from______
(Name of funding agency—list all agencies to which you have applied)
______
______
______
______
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