European Roma Rights Centre

Roma Rights Summer School 2013

Budapest–Hungary

APPLICATION FORM

INSTRUCTIONS
  1. Applications must be typed in English and fully completed.
  1. Please fill in all questions in the order that they appear and include all requested information; you may use as much space as you require answering each question.
  1. Documents – applicants must submit the following:
- Fully completed Application form
- One letter of recommendation (from a person familiar with your professional/extracurricular activities)
  1. All applications, including complete supporting documentation, must be received at the latest by 12 May 2013. Applicants are strongly encouraged to submit their applications in advance of this deadline.
    Applications as well as supporting documents must be sent by email – as attachments – to
    Applications may also be sent to:
For the attention of: Dora Eke, Roma Rights Summer School
European Roma Rights Centre
Madach ter 4, 1074Budapest,
Hungary
Fax : + 36 1 413-2201
  1. Late or incomplete applications will not be considered.
  2. An acknowledgment of receipt will be sent by email to all applicants.

SECTION ONE: PERSONAL INFORMATION

Family name (as in passport):

First name(s) (as in passport):

Date of Birth (day/month/year):

Country of Birth:

Ethnic Background: Romani Other:

Male / Female:

Tel (including country code):

Mobile:

Email:

Nationality:

Passport number:

Passport expiry date (day/month/year):

Maiden name of your mother:

Do you need a visa for Hungary?

Name of Emergency Contact:

Tel: ( )

Email:

Relationship to you:

Please list any health problems, allergies or dietary requirements.

Please provide a brief biography of yourself (150 words maximum).

SECTION TWO: LANGUAGE PROFICIENCY

Mother tongue:

1- Excellent (completely fluent) 3- Fair (able to perform socially)

2- Good (able professionally) 4- Poor (some knowledge)

Language / Speak / Read / Write / Understand
English
Romani
Other (specify)
Other (specify)

SECTION THREE: APPLICATION ESSAYS

Why do you wish to attend the 2013 Roma Rights Summer School? (600 – 1000 words)

Please describe your education background and achievements. (maximum 800 words)

Please describe your experience living and working in Romani communities and the human rights issues encountered. (maximum 800 words)

Please describe any human rights/Roma rights activities in which you have been involved to dateandhow your participation in the Roma Rights Summer School will assist your career? (maximum 800 words)

Please include any other information you believe relevant to your participation in the ERRC Roma Rights Summer School. (maximum 800 words)

DECLARATION

I hereby declare that the information provided is true and correct.

Name (printed) Date