Center for Reproductive Rights

Center for Reproductive Rights

South Asia Reproductive Rights Case Development Workshop (2012)

Application Form

Should you need more room to respond, please submit additional comments on a separate piece of paper attached to your application.

A. Personal Information

Last/Family Name ______First Name ______

Current Mailing Address: ______

Contact Number (with country code): ______

Mobile Number (with country code): ______

Email Address: ______

Describe your English language proficiency by marking one of the boxes in each row:

B. Education

Please, indicate with a symbol (*) those courses/classes/training mentioned bellow where the language of instruction or supervision was English.

Academic qualifications

Please list all academic education you have achieved since completing your secondary education:

• If applicable, list any courses you have taken on or related to international human rights and/or gender studies classes:

• Please note your licensing status in regards to your ability to practice law:

Professional trainings

Please list any training that you have received on human rights issues, including women’s rights and reproductive rights:

C. Work Experience

Please list your work experience:

For the essays below, please respond on a separate sheet and attach to the application. Please indicate which question you are answering in your response.

• C.1. Describe, in 250 words or less, any experience you have working on human rights and/or women’s rights issues (developing strategies to promote human rights and/or women’s rights; campaigning for legislative changes; providing legal advice; providing expertise at training workshops or educational seminars; preparing materials for publication, etc.).

• C.2. Describe, in 500 words or less, any litigation and/or other legal experience you have with national law in the area of human rights protection. If you are working on litigation, include a description of the types of court cases you are working on and the legal and other challenges you are facing working on those cases. Please make sure to include a description of any cases that include gender issues. If you are working on several cases related to gender, please, choose one or two cases that pose significant legal challenges. Please only include cases in which you have been directly involved.

• C.3. If you are currently working or studying outside South Asia, please describe your commitment to return to the region or to work on issues in the region.

• C.4. Please describe briefly your relationship to the organization/institution/firm that will support leave from your work to attend the training. Include whether you are a full time employee, part time employee, or on contract. If you have another type of employment relationship, please describe. Include your job responsibilities.

D. References

Please attach letters from 2 references, one of which must be a professional reference. If possible, please seek an academic reference for the second reference. If this is not possible, two professional references will suffice. Each reference should include in the letter answersto the following questions: (1) How long has the referee known the applicant? (2) What is her/his professional relationship to the applicant? (3) What is the quality and nature of the applicant’s work? (4) What is thecommitment of the applicant to work on issues concerning women’s rights or human rights? (5) How do you view the applicant’s potential to litigate cases in the field of reproductive rights?

If you are unable to attach the letters from your referees, please ask them to send the references to one of the addresses stated at the beginning of this application form.

Please, provide the following information about your referees:

First reference

Second reference

E. Programmatic Inquiries

For the essays below, please respond on a separate sheet. Please indicate which question you are answering in your response.

• E.1. Please provide a 1500 word or less proposal of a case that you would seek to litigate concerning access to safe abortion services or contraceptive information and services in your country if selected for this workshop. Briefly describe the legal strategy you would pursue if you were to litigate this case, including:
• In which forum (court or legal body) would you file this case?
• What legal arguments would you make?
• What is the potential for international and/or comparative law and jurisprudence?
• What remedies would you seek?
• What outcome do you anticipate?
• What steps do you need to take to file this case?
• What challenges do you anticipate in filing this case?
• How would this training contribute to your capacity to litigate this case?

• E.2. Briefly explain, in 250 words or less, your interest in reproductive rights issues and why you are interested in participating in the Case Development Workshop as well as your expectations from it.

• E.3. How did you hear about the Case Development Workshop?

□ A colleague□ A former partner organization

□ Internet research□ A friend

□ Listserv – please specify:□ Other – please specify:

______

F. Organizational Support Inquiries

Will the organization/institution that you currently work for support leave from your work so that you can attend the Case Development Workshop? If yes, submit a letter from the head of your organization/institution stating this as well as how your participation in the Case Development Workshop corresponds to your supporting organization/institution’s existing mission and priorities and how your training will likely be utilized to further the organization’s goals. Please also include a statement concerning how the case proposed above supports or is in line with the mission of your organization and whether your organization would support you allocating time to develop this litigation.

G. Check list of documents you must submit along with this application form

□ Curriculum Vitae

□ Letters from 2 references (see section D)

□ Letter of support from the head of your organization/institution (see section F)

□ Responses to essay questions C.1-C.4 and E.1-E.2

□ One copy of a legal petition that you have drafted

In signing this form I confirm that the information provided here and in other submissions to this application is correct.

Signature: ______Date:______

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