2016 FELLOWSHIP PROGRAMME FOR PEOPLE OF AFRICAN DESCENT
APPLICATION FORM
Deadline for Applications: 31 May 2016
This application form consists of two parts. While the first part must be completed by the candidate, the second part must be completed by the nominating organisation. Both partsneed to be completed and bear the original signature of the candidate and the nominating organisation. Applicants are requested to submit a completed form in addition to the documents listed below in a single e-mail .
Please answer each question clearly and completely. Type or print legibly.
PART I (To be completed by the candidate)
- First name:
(as noted in the passport)
- Family name:
(as noted in the passport)
- Date of birth (dd/mm/yy):
- Place of birth:
- Nationalit(ies) at birth:
- Present Nationalit(ies):
- Country of residence:
- Sex: Female/Male
- Marital Status:
- Number of dependents:
______
- Contact details of the applicant:
- Present address:
- Tel:
- Fax:
- E-mail:
______
- Educational qualifications:
University or equivalent / Attended from/to / Degree obtained / Main course of study
mm/yy / mm/yy
______
- Other human rights training:
______
- Present employer:
- Name of the employer:
- Address:
- Tel:
- Fax:
- E-mail:
- Present position:
- Date appointed:
______
- What is the human rights situation of People of African Descent in your respective country? And what are the challenges they are facing?
______
- Current work responsibilities relevant to the Fellowship Programme, and other experience related to promoting the rights of People of African descent:
______
- Otherprofessional experience in the field of human rights (in brief):
______
- List professional societies and activities in civic, public or international affairs in which you have been involved:
______
- How would you use the acquired knowledge at the end of the fellowship programme?
______
- Personal statement in support of your application (please write maximum 500 words and attach as a separate sheet)
______
- All briefing sessions of the fellowship programme are conducted in English. Therefore, fellowsmust be fluent in the English language to be able to participate fully.
I confirm that my command of English (spoken, writing and reading) is of the required standard
______
- How did you find out about the Fellowship Programme of People of African Descent?
OHCHR website
OHCHR email
Other international organisation / Other NGO
Word of mouth
Other (please describe) ______
- Have you or a relative ever participated in a fellowship or training programme organized by United Nations If yes, please indicate name of the programme, place and date.
- I enclose my:
Curriculum vitae
Personal statement
Letter of support from the nominating organisation
Copy of passport
- I certify that the statements made by me in answer to the forging questions are true, complete and correct to the best of my knowledge and belief.
Date ______Signature of applicant ______
PART II(To be completed by the nominating organisation)
- Nominating organisation:
- Name of the nominating organization:
- Address:
- Tel:
- Fax:
- E-mail:
- Short description of the organisation goals, objectives and work (additional information may be submitted through references to annual report, leaflet and publication, etc.):
- Present responsibilities of the candidate within the organisation:
- Reasons for nominating this candidate:
- Name and title of the certifying official:
- Signature of the certifying official: ______Date: ______
Please affix the organisations’
OFFICIAL STAMP