APPLICATION FORM

Please type or print in block letters

COURSES 2015

TO BE FILLED IN ELECTRONICALLY BY THE APPLICANT
1 / Family Name / 3 / Citizenship
2 / Forename(s) / 4 / Date of Birth (yyyy/mm/dd)

Application for

5 / Type of Course * / Date / Deadline for Receipt of Application
Core Course
/ 6 June – 18 June 2015 / 8 March 2015 *
Specialisation Course on
Human Rights
/ 19 June – 28 June 2015 / 8 March 2015 *
Core Course
/ 19 September – 1 October 2015 / 1 July 2015 *
Specialisation Course on
Conflict Transformation
/ 2 October – 11 October 2015 / 1 July 2015 *
Specialisation Course on
Election Observation and Assistance
/ 18 October - 24 October 2015 / 1 July 2015 *

* Course schedule is tentative as of January2015 and might be subject of change!

**Application deadline valid only for participants applying for scholarship!

Personal Details

6 / Sex
7 / Place of Birth
8 / Passport Number
9 / Mailing Address
9.1 /

Street

9.2 /

Postal Code + City

9.3 /

Country

10 /

Telephone

10.1 /

Work

10.2 /

Home

10.3 /

Mobile

10.4 /

Fax

11 / E-mail (compulsory)
12 / Emergency Contact
12.1 /

Name

12.2 / Address
12.3 / Contact Numbers
13 / Driving Skills
13.1 / Driving License
13.2 / Four Wheel Drive Experience
14 / Computer Skills / Word Excel Access Power Point Other

Higher Education

15 / Name and Location of University or Institution / Length of Studies
(in Years) / Diploma or Degree Obtained
15.1
15.2
15.3
15.4
15.5

Attendance of relevant Training, Seminars, etc.

16 / Year / Country / Institution / Type of Training, Seminar, etc.
16.1
16.2
16.3
16.4
16.5

Professional Experience (starting with most recent – please give details)

17 / Date
(from mmyy to mmyy) / Country / Organisation – Company / Title of Position / Main Tasks
(Short Description)
17.1
17.2
17.3
17.4
17.5

Outline former mission experiences and / or other relevant skills.

18

Language skills (please start with your native language)

19 / Language / Scale 1 – 3 (1 = Basic; 2 = Good; 3 = Excellent)
Understood / Spoken / Written / Read
19.1
19.2
19.3
19.4
19.5

Please outline your reasons for attending the course and your intentions with regard to future peace building activities (not more than 300 words)

20

I would like to apply for financial support because of reasons I have indicated in the

enclosed application essay (financial support for travel expenses is not possible).

Declaration of the Applicant:

By submitting this “Application Form” I confirm that all the information given in this form is correct and complete. I also confirm that I agree to the following conditions of participation:

I am motivated, willing and available to engage in civilian peace-keeping and peace-building activities abroad.

I will not arrive late or depart early.

I accept that the intensive character of the programme does not allow for any additional commitments during the course.

I agree that an assessment of my performance during the course will be made. This assessment will be treated as strictly confidential.

I understand that the training institution reserves the right to exclude the participant from the course in case information given in the form proves to be incorrect (i.e. insufficient language skills) or because of misconduct at the training site.

Privacy Note: We are concerned about the privacy interests and therefore committed to respecting privacy by using any personal information gathered in the most responsible way. The collected personal data will serve only for the purpose of participation in the training.

P l e a s e a t t a c h :

1. Curriculum vitae

2. Recent photograph

3. A copy/scanofthe data pageof yourpassport

4. Names, addresses and telephone numbers of two persons

whom we may contact as personal references

5. Health certificate in English, indicating current state of health

Please mail your application and all supplementary documentation to:

AUSTRIAN STUDY CENTER FOR PEACE AND CONFLICT RESOLUTION (ASPR) – IPT

Ms. Silvia Polster

Rochusplatz 1

A-7461 Stadtschlaining / Burg, Austria

Tel.: +43-3355-2498

Fax: +43-3355-2662

E-mail:

Website:

Please note that ASPR will acknowledge receipt of your application as soon as it is processed.

If you don’t hear back from us within a few days, please contact us again or resend the application!!!

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