Mekong School Application Form

Mekong School Application

Please give us the following information. If you do not want to send this information or you have any questions, you may contact us by email at mekong@earthrights.org.

Name:………....………........…………………………………………………………………

Date of Birth: …....……… Age:……… Sex: M / F Religion: ……………………

Ethnicity:……………...………………… Nationality: …………………………………

Languages that you can speak: ……………………………………………………………………

Marital Status: Single  Married 

Contact Information: (Please give at least one of the following.)

Address: ……………………………………………………………………………………
……………………………………………………………………………………

Telephone: ………………………………

Fax: …………………......………………..

E-mail: ........………………………………

Education

Highest Education Level Completed:……………………………………………………………..

What schools have you attended?

Name: ……………………………………… Location:………………Dates: ……………....


Name: ……………………………………… Location:………………Dates: ……………....


Name: ……………………………………… Location:………………Dates: ……………....


What trainings or workshops have you attended?

1. Name of Training:………………………………………....…………………………………

Organized by: ……………....………….... Location:………………………Dates: ……………....

2. Name of Training:………………………………………....……………………….…………

Organized by: ……………....………….... Location:………………………Dates: ……………....

3. Name of Training:………………………………………....……………………… ……………

Organized by: ……………....………….... Location:………………………Dates: ……………....

4. Name of Training:………………………………………....……………………………………

Organized by: ……………....………….... Location:………………………Dates: ……………....

5. Name of Training:………………………………………....……………………… ……………

Organized by: ……………....………….... Location:………………………Dates: ……………....

6. Name of Training:………………………………………....……………………… ……………

Organized by: ……………....………….... Location:………………………Dates: ……………....

Work History

Where are you currently working? (Name of Organization) ……………………………………….

………………………………………………………………………………………………………..
Address:

……………………………………………………………………………………………..

………………………………………………………………………………………………………..

Current Position:……………………………………………………….......……………………...

Responsibilities/Duties: ………………………………………………………...................……….

……….............……….............……….............……….............………...................………………..

How long have you worked here? …….…………………...………………………………………

What other jobs do you or did you have? These can be paid or unpaid positions.

Job title: ……………………………………… Organization:………...………………………….

Location: ……………………………………… Dates:………………………............……………

Responsibilities/Duties: …………....……………………………………………………………….

…………………………………………………………………………………………………….....

Job title: ……………………………………… Organization:…..……………………………….

Location: ……………………………………… Dates:………………………............…………...

Responsibilities/Duties: …………....………………………………………………………………

……………………………………………………………………………………………………...

Job title: ……………………………………… Organization:…..……………………………….

Location: ……………………………………… Dates:………………………............…………...

Responsibilities/Duties: …………....………………………………………………………………

……………………………………………………………………………………………………...


Name of the persons writing your recommendation letters:

1. Name: …………………………………………….. Organization: ……………………………

Address: ……………………………………………………………………………………………

…………………………………………………………………………………………….

Telephone: …………………………………………………………………………………………

Email Address: ……………………………………………………………………………………..


2. Name: ……………………………………………..... Organization: ………………………….

Address: ……………………………………………………………………………………………
…………………………………………………………………………………………….

Telephone: …………………………………………………………………………………………

Email Address: ……………………………………………………………………………………..



Please return to the following addresses by March 10, 2008:
Contact Person: Mekong Program Coordinator
E-mail: mekong@earthrights.org
Mail: P.O. Box 123
Chiang Mai University
Chiang Mai 50202 THAILAND


Application Essays

Please answer the following questions in short essays (3 paragraphs each, no more than 350 words) (1 to 2 pages each) and send to us by post or e-mail by March 10, 2008.. (Please answer in English).


1. What problems do you think happen to people and the environment from large-scale hydropower development projects? Explain these problems in detail using your own words. Give specific examples of problems you know about when possible.



2. During the ERS program you will be asked to investigate an issue relating to hydro-development, water issues, and international financial institutions. Think about your own experiences with these topics, what problem or issue would you like to learn more about? Please explain how and where you could find information about this topic. (In your own words, answer this question in English)




3. What difficulties do civil society organizations face in the Mekong basin when they campaign on issues relating to hydro-development, water issues, and international financial institutions? How do you think these difficulties could be overcome?




I certify that I wrote these essays by myself. Signed __________________________

Please return to the following addresses by March 10, 2008
Contact Person: Mekong Program Coordinator
E-mail: mekong@earthrights.org
Mail: P.O. Box 123
Chiang Mai University
Chiang Mai 50202 THAILAND


ERS Mekong Training Program 2008

RECOMMENDATION FOR ………………………………………………………
(Name of Applicant)


SECTION 1:

Name: ………………………………………………………
Name of organization ………………………………………………………
Responsibility within organization ………………………………………………….......

SECTION 2:

Please answer the following questions:

How long have you know the candidate?: ………………………………………………..
……………………………………………………………………………………………..
……………………………………………………………………………………………..

Please explain your relationship to applicant:
………………………………………………………………………………………………
………………………………………………………………………………………………
………………………………………………………………………………………………

Please comment on why you support the applicant’s candidature for the ERS Mekong program:
………………………………………………………………………………………………
………………………………………………………………………………………………
………………………………………………………………………………………………

Please comment on the applicant using his or her knowledge about Human Rights and the Environment in the future:
………………………………………………………………………………………………
………………………………………………………………………………………………
………………………………………………………………………………………………
SECTION 3:

Please give an assessment of the applicant skills and abilities in the following areas.

Please write a number between 1 and 5.

Note: 1 = Not sure / 2 = Poor / 3 = Good / 4 = Very Good / 5 = Excellent

Applicant’s ability to remain independent: (.………)

Applicant’s level of maturity (……….)

Applicants ability to grow and develop skills and experience (……….)

Applicant’s ability to act responsibly and take responsibility for own actions: (……….)

Applicant’s level of motivation: (……….)

Applicant’s tolerance of difference and diversity in race, religion, gender, sexual orientation etc.: (……….)

Ability of applicant to foster friendly and productive community relations: (……….)

Ability of applicant to apply knowledge and skills to real life situations: (……….)

Ability of applicant to communicate openly and reasonably: (……….)

Ability of the applicant to work in team settings: (……….)

Applicant’s experiences/interest in human rights & environmental issues: (……….)

Applicant’s ability to communicate in the English language: (……….)


Please use the following space to make any other relevant comments about the applicant:

…………………………………………………………………………………………….

…………………………………………………………………………………………….

…………………………………………………………………………………………….

…………………………………………………………………………………………….

…………………………………………………………………………………………….

…………………………………………………………………………………………….


I ------------------------ certify that (Name of Applicant) -------------------------- is a strong and suitable candidate for admission into the EarthRights Mekong School training program for the year 2008.
Signed: ………………………………………………………………………………….
Date: …………………………………………………………………………………….

Please return to applicant or send directly to
Contact Person: Mekong Program Coordinator
E-mail: mekong@earthrights.org
Mail: P.O. Box 123
Chiang Mai University
Chiang Mai 50202 THAILAND