Application Form

PLEASE NOTE: Make sure to save a copy of this PDF to your computer before you fill it out. If you fill it out online any data you enter will be lost when you close.
790KB Sizes 0 Downloads 287 Views
PLEASE NOTE: Make sure to save a copy of this PDF to your computer before you fill it out. If you fill it out online any data you enter will be lost when you close your browser

Global Awareness Programme 2015 - Application Form Please save, type and print: NAME AND LOCATION OF CURRENT COLLEGE/EMPLOYER (if applicable)

APPLICANT DETAILS Name on passport:

Name: Location:

Address: Passport Number:

Have you applied for a Travel Award in a previous year?

Date of birth:

Male ☐

Yes ▢

Age on 1 June 2015:

Female

If “Yes” what year?

st

For which Global Awareness Programme are you applying? Tick only one.

Nationality: Current occupation:

If you wish to apply for more than one award you must complete a separate form for each application.

Mobile: Tel:

*Separate unique application forms for the ACCESS, Global Awareness, Mature Student, Youth Activist, ECTP, Active Retirement & China Travel Awards can also be requested online.

Email: Emergency Contact Name: Relationship:

No ▢

HIV & AIDS ▢

Environment ▢

Mobile: Email: EXPERIENCE AND MOTIVATION (attach another sheet if necessary)

Please describe any volunteer or community service activity you are or have been involved in.

Please outline your reasons for wanting to participate in this programme?

Have you ever travelled or lived abroad?

Please list any skills, talents, or attributes, which you would bring to this programme.

Please describe any hobbies or interests that are important to you.

1

Do you think that this programme will contribute to your personal development? How?

To what extent do you think your attitude, your way of thinking and/or your values may change while on the programme?

How do you plan to follow up your experience on your return?

To complete your application you must: Write a short essay (no more than two A4 Pages) or send on a video (no longer than 2 minutes) about the:

• About the importance of raising awareness in Ireland about HIV & AIDS and how you would go about this on your return

Or

• About the importance of raising awareness in Ireland about Environmental Sustainability and how you would go about this on your return. • Include your current CV • Include 2 passport photos

TERMS AND CONDITIONS

• Applicants need to demonstrate an appropriate level of • Entries must include this completed form, a completed

maturity and responsibility in order to participate.

• Selected participants shall forfeit their Award should they

reference form and the above essay/project/video, two not be able to fully participate in the programme on all the passport photos and up-to-date CV. Deadline for dates as specified including the pre-departure orientation application is 12 noon Tuesday 10 March 2015.* and/or should they be found unfit to travel by a medical *If you are submitting your hard copy application by post very close to practitioner. the deadline we require you to: Post original in any An Post letterbox/office up until Tuesday 10th March 2015 and email a full • All applicants agree to accept the decision of the EIL adjudication panel as final. scanned copy of the entry to [email protected] before 12 noon Tuesday 10th March 2015. • Shortlisted candidates must be available for interview in • Shortlisting may take place and interviews will be Dublin on Sat 28 March 2015. conducted prior to final selection. • Winners will be announced in April 2015. • Each successful applicant must complete all necessary • If selected to participate, I agree to participate in the all supplementary application forms as required by EIL the training days detailed online http://eilireland.org/travelawards/global-awareness-programme (including parental/guardian permissions if under 18). th

th

Declaration: I confirm that all of the information given above is true to the best of my knowledge and I have read and fully accept the terms and conditions as outlined above. Signature: _____________________________________________

Date: _________________

2

REFERENCES

Please provide 2 referees (one of whom should be your employer or teacher) who we can contact in relation to you application

1. Name:

Occupation:

In what capacity do you know this person?

Tel:

Email:

2.Name

Occupation:

In what capacity do you know this person?

Tel:

Email:

Please make sure your references are informed about your application and are available to be contacted.

DOCUMENT CHECKLIST

Please check that you have the following completed with your application

2 recent passport-sized photos An up-to-date CV Application form References A copy of your essay/video

• •

Send to: Experiment in International Living, 1 Empress Place, Summerhill North, Cork City, Ireland. Deadline for application is 12 noon Tuesday 10 March 2015.* th

*If you are submitting your hard copy application by post very close to the deadline we require you to: Post original in any An Post letterbox/office up until Tuesday 10th March 2015 and email a full scanned copy of the entry to [email protected] before 12 noon Tuesday 10th March 2015.

3