wief young fellows programme 2012 - application form pdf

7/31/2019 WIEF Young Fellows Programme 2012 - Application Form PDF

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WIEF YOUNG FELLOWS PROGRAMME

2nd

Floor, Kompleks Antarabangsa

Jalan Sultan Ismail

50250, Kuala Lumpur, Malaysia

Tel: +603 2145 5500

Fax: +603 2145 5504

Web: www.wief.org

APPLICATION FORM 2012

Who can apply

Fresh graduates, young entrepreneurs, civil society leaders, community workers, researchers,junior professionals,who are between the ages 20-25, and have a seed of an idea that they wantto develop into a full-grown project.

Preference will be given to applicants who can demonstrate how this Programme will directlybenefit them, their community and their country.

Proficiency in English is required. If you are accepted you will be required to participate fully inthe discussions and role-plays in English.

How to apply

WIEF Young Fellows Programme 2012 is a free of charge event. Successful candidates needto pay only for their flights. Accommodation and transportation during the programme period,programme materials and basic meals are covered by the organizer.

Please send these details to the postal address above or via email at [email protected]:1. completed application form below2. your CV3. letter of recommendation4. passport-sized photo

CLOSING DATE OF APPLICATION: 31 July 2012 Applicants will be notified of the outcome of selection latest on 7 August 2012 (earlier applicants

will be notified earlier.)

Participants are responsible for arranging and funding their round-trip travel from home countryto Malaysia. No request for financial support can be considered. Participants are expected to seekfinancial support from their own organization and/or other foundations.

Participation

As an annual programme, we only have spaces for 20 young leaders every year. It is a privilege if you areselected for this programme as you are chosen amongst hundreds of applicants. We therefore expect youto commit yourself fully in the programme, and attend all the programme sessions.

Cancellations

Please think before you register. Make sure you really can make the time to participate because if you

cancel at the last minute, it is one opportunity lost to a young leader out there.
mailto:[email protected]


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2nd


Jalan Sultan Ismail


Tel: +603 2145 5500

Fax: +603 2145 5504

Web: www.wief.org

PERSONAL INFORMATION

Title: (Mr, Mrs, Ms etc.) Name: (Please underline family name)

Male/Female: Date of Birth:

Age: Country of Birth/Nationality:

Country of Residence:

CONTACT DETAILS

Postal Address:

City: State:

Country Postal Code:

Phone Number: (including country code)

Mobile Number: (including country code)

Fax number: (including country code)

Email Address:

Alternative e-mail address:

PASSPORT / IC (Malaysian) DETAILS

Passport / IC Number: Citizenship:

Country Issuing Passport: Issue Date: Expiry Date:

WORK EXPERIENCE (if any)

Name of organization/cause you work for/are associated with :

Current Position (include specific job responsibilities if any):


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2nd


Jalan Sultan Ismail


Tel: +603 2145 5500

Fax: +603 2145 5504

Web: www.wief.org

Milestones at work (awards or recognition won):

Outline briefly the reasons why you would like to participate in theWIEF Young Fellows Programme 2012.Please explain how this program relates specifically to you and or your work or situation.

Where do you see the impact of your acquired skills from this Programme, in your community/country/workplace?

Describe briefly an idea, campaign or a project on which you are, or have worked, or would like to work on that youthink you want to share and develop in this programme.

EDUCATION

What level of education have youcompleted? Please markX in theappropriate square

Secondary /High School

Technical /Vocational

Diploma UndergraduateDegree

PostgraduateDegree

Name of academic institution:(Please list all colleges, universities, and professional schools attended, stating the year of attendance for each.)

Degrees/courses successfully completed:(Please list the names of degree courses/certificate earned, including the year awarded.)


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2nd


Jalan Sultan Ismail


Tel: +603 2145 5500

Fax: +603 2145 5504

Web: www.wief.org

Academic awards (if any): (Please list awards earned during study e.g. Deans Top Student Award, Best Student in Faculty etc.)

Other training, including previous conferences/programmes attended: (Please give details)

LANGUAGE

Is English your mother tongue? YES ( ) or NO ( )

(If your mother tongue isnotEnglish, please answer all the following questions as fully as possible.)

How have you learnt English?

How often do you use English?

Where do you use English?

Rate your English ability using the scale: 1=fair, 2=good, 3=excellent

Spoken English: ______ Written English: _______ Comprehension: _________

Please write a short essay on If I have the power to change the world. (one page, minimum 1000 words)


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2nd


Jalan Sultan Ismail


Tel: +603 2145 5500

Fax: +603 2145 5504

Web: www.wief.org

REFERENCE LETTER( Enclosed or Sent separately )

Please include a letter of recommendation from your referee.Your reference should be from the head of your organization/immediate work supervisor/university lecturer/head ofyour project.Letter should be a maximum of one page in length. Please ask your reference to address the following questions:

1. What is the role of the applicant in their organization?2. Will the applicants participation in this program impact positively on his/her work?3. Why do you feel this candidate will benefit fromWIEF Young Fellows Programme 2012?4. Please confirm English proficiency of applicant.5. Please include any other information you think is relevant.


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2nd


Jalan Sultan Ismail


Tel: +603 2145 5500

Fax: +603 2145 5504

Web: www.wief.org

Referee Details

Name:Organization:Address:

Relationship:Email:Phone: (including country / district area codes)

How did you hear about this Programme?

SPONSORSHIP (FOR OVERSEAS PARTICIPANTS)

You will need to consider whom to approach to sponsor yourtravel expenses.

Do you have funding for travel expenses?

If you do not have funding, do you need an acceptance letter to help secure funding?

TRAVEL INSURANCE

All participants from outside Malaysia must have their own travel insurance. The cost of medical care in Malaysia isexpensive. If you do not have travel insurance then you may not able to attend the program. (to be provided once acceptedand flight booked )

Name of Insurance Company: ______________________ Policy number: ______________________

EMERGENCY CONTACT INFORMATION

Name:

Relationship to candidate:

Tel: Email:

Mailing address:

Position and Organization: (please state the position, and the name of your organization)


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2nd


Jalan Sultan Ismail


Tel: +603 2145 5500

Fax: +603 2145 5504

Web: www.wief.org

CONSENT

Do you give us consent to use the information provided in this form to write a short biographical paragraph aboutyou that will be given to trainers, participants and others for the purposes of informing them, seeking funding onyour behalf, advertising this programme and in futureWIEF Young Fellows Programme 2012 publicity material?

YES ( ) or NO ( )

SIGNATURE AND PHOTOGRAPH

I certify that the information I have provided on this application form and in any attached materials is true andcomplete.

Full signature ________________________________

Date: __________________

Thank You for Your Application!

______________________________

About WIEF

The WIEF Foundation, a not-for-profit organisation based in Kuala Lumpur, organises the annual WorldIslamic Economic Forum, a world-class business platform showcasing business opportunities in theMuslim world, and to run programmes of the various initiatives of the Foundation that strengthenspeople partnership and knowledge exchange between Muslim and non-Muslim communities across theglobe. The Foundation aims to tackle problems in the Muslim world strictly from a business perspective,and to build bridges through business between the Muslim and non-Muslim world.

Please attach

passport

photograph

wief young fellows programme 2012 - application form pdf

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