Bali Youth Event Application Form FINAL

8/12/2019 Bali Youth Event Application Form FINAL

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Youth Event at the 6 th UNAOC Forum in Bali, Indonesia 28 August 20 !

Application form

DEADLINE TO APPLY: 30 June 2014

T pe of application

T!e "NAO# $orum an% Yout! E&ent 'ill 'elcome at total of 100 eli(i)le out!* T!e)rea+%o'n of t!e,e 100 out! participant, i, a, follo',: 40 place, for Internationalparticipant, an% -0 place, for In%one,ian participant,*

Are ou appl in( a, an .international/ participant or a, a participant from .In%one,ia/

Type of applicant: __________________________

Applicant i%entification

$ir,t name (given name) A" I# A$$EA%" IN $A""$O%#

i%%le name (if applicable) A" I# A$$EA%" IN $A""$O%#

La,t name (surname/familyname)

A" I# A$$EA%" IN $A""$O%#

#omplete name A" I# A$$EA%" IN $A""$O%#

en%er

Date of )irt!



&I#' FO%(A# ))*((*YYYY

#urrent a(e

#ountr of )irt!

#urrent countr of re,i%ence

#urrent nationalit

Pa,,port num)er

#ountr '!ic! i,,ue%applicant , pa,,port

Date of i,,uance of applicant ,pa,,port +&I#' FO%(A#

))*((*YYYY

E pir %ate of applicant ,pa,,port +&I#' FO%(A#))*((*YYYY

#urrent complete mailin(a%%re,,

P!one num)er (includingcountry code)

E5mail a%%re,,

Applicant )ac+(roun%

6!at i, our current mainoccupation (e.g. student,intern, volunteer, professional,looking for employment, etc.) Plea,e pro&i%e more %etail,

(e.g. sector of employment, leveland discipline of studies, etc.)

Are ou a mem)er of t!e out!5lea% or(ani7ation

Yes / No

If e,8 '!at i, t!e name of t!eor(ani7ation ou repre,ent



If e,8 '!at are t!e o)9ecti&e,or area, of 'or+ of ouror(ani7ation

If e,8 '!at i, our po,ition

'it!in t!i, or(ani7ation

If e,8 '!at i, t!e 'e),ite ofour or(ani7ation

Do ou !a&e an e perience inout! acti&itie, f yes, please

provide details about t!e activitiesand your responsibilities

Yes / No

"etails:

Di% ou atten% an of t!e

follo'in( "NAO# $orum,:#adrid $%%&' stanbul $%% ' iode *aneiro $%+%' "o!a $%++'

ienna $%+-

Yes / No

f yes, !ic! one

E,,a ue,tion,

1: 6!at i, our currentin&ol&ement ;e*(* 'or+8,tu%ie,8 &olunteerin(8 etc*< in

t!e topic, of t!e "NAO# =ali$orum esponse s!ouldinclude appro0imately +1% ords.

2: >o' %o ou (enerall %eal 'it! cultural or reli(iou,%ifference, Plea,e pro&i%e aconcrete e ample*

esponse s!ould includeappro0imately +1% ords.

3: 6! %o ou 'ant to ta+epart in t!e - t! "NAO# $orum in=ali an% it, Yout! E&ent


4: Plea,e ,!are our t!ou(!t,on t!e t!eme of t!e $orum8 i*e*



."nit in Di&er,it : #ele)ratin(Di&er,it for #ommon an%?!are% @alue,/* >o' are unitan% %i&er,it lin+e% >o' are%i&er,it an% ,!are% &alue,lin+e% esponse s!ould include

appro0imately $1% ords.

: Plea,e ,!are our t!ou(!t,on t!e t!eme of t!e Yout!e&ent8 i*e* .T!e role of out! inpromotin( ."nit in Di&er,it /t!rou(! e%ucation8 me%ia an%mi(ration/*

esponse s!ould includeappro0imately $1% ords

-: If ou are ,electe% toparticipate in t!e Yout! E&entan% t!e $orum8 '!at 'ill )e

our ,trate( to u,e t!e ,+ill,8+no'le%(e an% connection,

ou 'ill !a&e (aine% once ouare )ac+ !ome


B: 6oul% ou )e a)le to rai,e

a'arene,, on t!e Yout! E&entan% t!e $orum upon ourreturn in our !ome countrOn '!ic! net'or+, can oucount to multipl t!e impact of

our participation in t!e$orum esponse s!ouldinclude appro0imately +1% ords.

Ot!er ue,tion,

Do ou nee% a &i,a to enterIn%one,ia

Yes / No

I, our pa,,port &ali% until$e)ruar 201 ;If ou nee% a&i,a to In%one,ia8 ourpa,,port nee%, to )e &ali% for -

Yes / No



mont!, after our entr inIn%one,ia<

6!at i, our le&el of ,po+enEn(li,!

20cellent / 3ood / 4air / 5oor

Do ou !a&e an %ietarre,triction, ;All foo% offere%for participant, 'ill )e Co,!er >alal or @e(etarian<

Yes / No

f yes, please provide more details:

6!at i, our !ealt! ,tatu,5lease outline any prescriptionmedications and/or medicalconditions or allergies you mig!t!ave t!at t!e organi6ers need tokno about. f you do not !ave

any, please rite 7none7.T!is information ill be keptconfidential and ill be only usedin case of emergency.

20cellent / 3ood / 4air / 5oor

8omments:

Plea,e pro&i%e emer(enccontact name8 num)er an%email a%%re,,

Name of emergency contact:8ountry of residence of emergency contact:

elations!ip to t!e applicant:Telep!one number:2mail:

#!ec+li,t

Di% ou complete e&er ,ection of t!e Application form Yes /No

Doe, our name in t!e application form matc! e actl our name in ourpa,,port

Yes /No

Di% ou re,pect 'or+ limit for t!e e,,a ue,tion, Yes /No

Di% ou ,a&e our application form 'it! t!e follo'in( format:

$ir,tNameLa,tNameApplication*%ocE ample: Jo!n?mit!Application*%oc ;Plea,e +eep application in 6or% format<

Yes /

No

Di% ou inclu%e a cop of t!e i%entification pa(e of pa,,port;In PD$ format8 prefera)l <

Yes /No

Di% ou ,a&e our pa,,port 'it! t!e follo'in( format:$ir,tNameLa,tNamePa,,port*p%f

Yes /No



E ample: Jo!n?mit!Pa,,port*p%f

Di% ou attac! our Fe,ume8 in En(li,!8 2 pa(e, ma imum;In 6or% format8 prefera)l <

Yes /No

Di% ou ,a&e our Fe,ume 'it! t!e follo'in( format:

$ir,tNameLa,tNameFe,ume*%ocE ample: Jo!n?mit!Fe,ume*%oc

Yes /

No

Atte,tation

I atte,t t!at t!e informationpro&i%e% a)o&e ;an% ana,,ociate% information '!ic! I!a&e pro&i%e% in reference tot!i, application<8 i, true an%

complete*

I reco(ni7e an% accept t!atpro&i%in( fal,e8 mi,lea%in(8 orintentionall incompleteinformation 'ill pro&o+eimme%iate refu,al of mapplication*

Yes / No

Date (""/##/YYYY)

ue,tion, re(ar%in( t!e application form:9!ould you !ave uestions regarding t!is application form, please contact t!e organi6ers oft!e Yout! 2vent at )aliGunaoc out!*or( *

#!ec+in( our application pac+a(e:n order to be considered valid and complete, your application package must include:+)T!e complete application form, saved in t!e follo ing format:

4irstName;astName<pplication.doc'$)+ copy of your international passport=s identification page, save in t!e follo ing format:

4irstName;astName5assport.pdf

-)Your esume, in 2nglis!, ma0imum $ pages, saved in t!e follo ing format:4irstName;astName esume.doc

f your application package is not complete or not saved according to t!e proper format, it ill not be revie ed.

?u)mittin( our Application pac+a(e:

mailto:[email protected]




You need to send your <pplication package by email to )aliGunaoc out!*or( ) 11: H P;Ne' Yor+ time< on 30 June 2014 at t!e very latest. T!e title line of your email needs to beyour first name follo ed by your last name. 20ample: *o!n9mit!. <pplication packagesreceived after t!is deadline ill not be considered.

$ee%)ac+ proce,,

<ll applications ill be revie ed by t!e organi6ers in *uly $%+>. <t t!e end of *uly $%+>, onlyt!e selected participant ill be contacted and informed about t!e ne0t steps in logisticalarrangements (c!eck guidelines).

<pplicants t!at are not selected ill receive a generic message at t!e end of *uly $%+>.



Documents

Bali Youth Event Application Form FINAL