40 Scotts Road #20-00

Environment Building

Singapore 228231

Tel: 1800 2255632

E-mail:

www.nea.gov.sg

YOUTH ENVIRONMENT ENVOY PROGRAMME

Induction Workshop

APPLICATION FORM

FULL NAME
(AS APPEARS ON NRIC / PASSPORT) / NRIC / PASSPORT NO / GENDER
MALE
FEMALE
HOME ADDRESS
HOME PHONE / MOBILE PHONE / EMAIL ADDRESS
DOB (DD/MM/YYYY) / PLACE OF BIRTH / CITIZENSHIP
SCHOOL / EMPLOYER / SCHOOL / OFFICE ADDRESS
AREA OF ENVIRONMENTAL INTEREST
What topics are you interested in? Please rank the top 3 topics, with most interested as 1, and third most interested as 3.
You may state another topic in addition to three topics that you have ranked.
Food Waste / Public Health (rats / dengue)
Plastic Waste / Public Hygiene (litter-free)
E-Waste / Campus Sustainability
Climate Change / Pollution
Energy Efficiency / Others:
WORKSHOP RUN
(choose one) / RUN 31: 24 TO 25 SEPTEMBER 2016 (SATURDAY AND SUNDAY)
SPECIAL DIETARY REQUEST (IF ANY)
HOW DID YOU KNOW ABOUT THIS PROGRAMME?

NEA respects and shares your concern about privacy. Protecting your personal information is a priority. We do not rent, sell or exchange your personal information to any third party without your express permission.

By checking this box, I agree to be notified by NEA about NEA and partner programmes via email and/or mobile.

For the open ended questions below, please use the given space as much as possible. This will help us to better assess your application. Do note that you may be called for a short interview.

1.  Describe your involvement and contributions (leadership and non-leadership) in any environmental projects, initiatives, studies, or activities (e.g. projects that influence others to care for the environment, recycling collection drives, upcycling workshops, beach clean-ups, nature guiding, etc.
Please include: name of organisation(s); the position(s) held, period of and description of your involvement.
List three (3) environmental projects and ambitions that you will embark on in the next 12 months. Please include details such as the project name, organisation name, description and objectives.
2.  Indicate how you expect your involvement in this programme could be applied to roles pertaining to environmental sustainability that you are already in or may wish to embark upon.


CHARACTER REFERENCES

Please provide details of two (2) character referees:

Note: Personal – People who know you on a personal level but not your family members, relatives, partners etc.

Professional – People who have worked with you either in your employment, volunteering experience etc.

PERSONAL
FULL NAME / GENDER / MALE
FEMALE
OCCUPATION / RELATIONSHIP
ORGANISATION / LENGTH OF TIME KNOWN TO PERSON
EMAIL ADDRESS / MOBILE
PROFESSIONAL
FULL NAME / GENDER / MALE
FEMALE
ORGANISATION / RELATIONSHIP
DESIGNATION / LENGTH OF TIME KNOWN TO PERSON
EMAIL ADDRESS / MOBILE

Please send the completed application form to:

Mr Darren Tan

Schools & Youth Department

Tel: 6731 9117

Email: .

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Youth Environment Envoy Programme