The 20th Asia Pacific Youth Conference
Taiwan, 2nd to 9th August 2014
“Building Trust Across the World’s Divides
–Youth’s Roles and Responsibilities”
Registration Form
Dr /Mr /Mrs /Ms Family name as on passport: …………………......
Given name(s) as on passport: ……...... ……..………………......
Name which you prefer to be called: ………………………………………………………………………..
Contact address: ………………......
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Nationality: ...... Occupation: ………………......
Phone: ...... Fax: ......
Email: ...... …...... …...... … Date of birth (D/M/Y): ......
Passport No: ...... Expiry date (D/M/Y): ......
Emergency contact (name and phone): ......
The main communicating language of APYC will be English. Please give your considered and honest response to the following questions (circle the answer):
Is your spoken English: very good / good / fair / weak?
Is your understanding of written English: very good / good / fair / weak?
By: Rail
Road
Ship
Air
Meals (Please circle): Vegetarian Non-vegetarian
Allergies/Food requirement: ......
Reasons for wanting to participate this APYC: ……………………………………………………………
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Prior experience with the IofC network and/or its program(s)
NO YES (please specify) …………………………………………………………………..
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If your answer is YES, please provide a reference person within the IofC network.
Name: ______
Email: ______Phone: ______
Applicant’s Signature: ______Date: ______
Please complete all questions and send your application form by Fax or Email
Organizer: Initiatives of Change Taiwan
15 Lane 772 Gongyuan Road, Tainan, Taiwan 704
Phone: +886(6)2820320 Fax: +886(6)2820330
E-mail: Website: apyc.iofc.org (for online application)
All applications must be received by 31 March 2014
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About APYC Scholarship
(skip this part if you are not applying for a scholarship)
In order to encourage equal participation across the Asia Pacific region, the conference offers limited amounts of scholarship to cover part of the travel cost and conference fee for those applicants who are from developing economies and are in real financial needs. All applications will be considered by the organizer through consultation with the APYC international committee and the national IofC bodies concerned before a formal decision is made. If you would like to apply for a scholarship, please state your reasons along with the requested amount and provide the contact information of a reference person within the IofC network.
I would like to apply for a scholarship of USD ______because………………………………….
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Name of Reference Person: ______
Email: ______Phone: ______
Note: acceptance of an application does not necessarily grant the applicant a scholarship.