2012PILnet International Fellows Program

Application Form

Please be sure to read the program announcement accompanying this application carefully before submission. For clarity, please print in capital letters or type.

I. Personal Information

Name (last name, first name):

Personal mailing address:

Telephone:

Fax:

Email address:

II. Employment

Present place of employment:

Address:

Telephone/fax/e-mail:

Name of immediate supervisor:

Position:

Date of membership in your country's bar association:

III. Languages

English: Please note level and provide a copy of your TOEFL report or other English language test, if possible.

ElementaryIntermediateGoodAdvanced

Spoken 

Reading 

Written 

Other languages (use additional space, if necessary):

ElementaryIntermediateGoodAdvanced

Spoken 

Reading 

Written 

IV. Statement of interest

Describe relevant previous experiences in public interest advocacy activities (maximum 1,000 words)

V. Attachments

Applicants MUST submit the following documents (all non-English materials must be accompanied by an English translation):

  • A completed program application form;
  • A curriculum vitae or resume;
  • A nominating letter from the organization where they are employed supporting their application to the program and indicating how the Fellowship would be a benefit to the organization/institution;
  • Two recommendation letters (in addition to the nominating letter), at least one from an individual outside of the nominating organization (additional recommendations welcome);
  • A description of a project that the applicant would like to work on during the first semester of the program, ideally with practical significance to their work upon return home;
  • A copy of the applicant's law school transcript;
  • A copy of the applicant’s bar membership if available;and
  • Information on the nominating organization/institution.

The DEADLINE for receiving applications at PILnet is 19 March 2012.Applications should be sent by electronic mail or regular post to:

Erin Carll

Program Coordinator

333 7th Avenue, 14th Floor

New York, NY 10001, USA

E-mail:

I hereby certify that to the best of my knowledge, all the information included in this application is correct.

Signature Date

1