257 esd-application 2011 web

8/3/2019 257 ESD-Application 2011 Web

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(When necessar/appicae)

The Noination is approved (nae o athorisin athorit) __________________________________________________in accordance with oca res.

Date ________________________ Sinatre o athorisin athorit ______________________________________________________________________

The ________________________________________________________________________________ Contr ___________________________________

(nae o noinatin oranisation/instittion/copan)

noinates ______________________________________________________________________________________________________________________

(nae o appicant)

to the Programme Education or Sustainable Development in Formal Education, in Sweden, September 1230, 2011

and in South Arica or Arican participants and in India or Asian participants in November/December, 2011

Reasons or noination ___________________________________________________________________________________________________________

(oiator)

_______________________________________________________________________________________________________________________________

The noinatin oranisation/instittion coit itse to provide the necessar tie and resorce spport to the participatin tea towards enhancin

their ESD-wor in their oranisation/instittion.

Date ___________________________________________________________________________________________________________________________

Sinatre o noinatin oranisation/instittion/copan _______________________________________________________________________________

The Appication shod e sitted to the appropriate SwedishEass/Consate at the atest on February 7, 2011.The Eass/Consate wi orward it to the prorae secretariat.

I no appropriate Swedish Eass/Consate in the contr,pease sit appication or direct to secretariat at theatest on February 7, 2011.

PHOTO

(Pease do not e.

Attach with Stape)

FOR OFFICIAl uSE OF THE SWEDISH EmbASSy

Received appication adinistration:

Sin ______________________ Date ____________________

Coent, see attached note

Appications received ater Ferar 7, 2011 wi not e considered.

Prorae in Edcation or Sstainae Deveopent in Fora

Edcation (257)

Sweden, Septeer 1230, 2011

and in Soth Arica or Arican participants

and in India or Asian participants, in Noveer/Deceer, 2011

Ramboll Natura AB

ITP Prorae Secretariat

P. O. box 17009

SE-104 62 Stocho

SWEDEN

Phone +46 10 615 60 00

Fax +46 10 615 20 00

[email protected]

www.raonatra.se

ms. marie Neeser, Prorae Director

[email protected]

ms. mia Zacco, Ad. Co-ordinator,

[email protected]

APPlICATION FORm (Tpewritin or oc etters)


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PERSONAl HISTORy (write as it appears in or Passport)

EmPlOymENT RECORDA. Present position

1. First nae (underline name by which formally addressed) Second nae Fai nae (surnae)

2. Ofce address 3. Teephone (to ofce). (countr code/area code)

Fax no.

E-ai (oiator)

4. Hoe address 5. Teephone (hoe) (countr code/area code)

mobie phone:

E-ai (hoe):

6. Nationait Date o birth Da month year

7. Sex mae Feae8. Nae and address o person to be notifed in case o eergenc (inc. countr code/area code)

Teephone: E-ai:

9. Education (start with ast attended institution and work backwards)

Nae o institution and pace o stud major feds o stud years o stud ro to Degrees

10. list ebership o proessiona societies or other activities in civi, pubic or internationa aairs

11. list an reevant pubication ou have written (do not attach)

12. Previous residence in oreign countr in reation to appicants proessiona or stud interest

Have ou participated in an training prograe in Sweden beore?

es no Nae o prograe, ear ____________________________________________________________________________________

Tite o or post Description o or wor, incdin or persona responsiiities

years o service: ro to

Tpe and eve o oranisation

Nae o spervisor (i an)

Nae and address o epoer

In order to ae or appication copete, pease ive detais o or dties

and responsiiities or or present and previos positions


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CASE STuDy / CHANgE PROjECT

b. Previos position

Pease state rief the reason or appin to this prorae, or ain ed o interest within the prorae and how o hope to enet

ro the prorae.

Tite o or post Description o or wor, incdin or persona responsiiities

years o service: ro to

Tpe and eve o oranisation

Nae o spervisor (i an)

Nae and address o epoer

One e eeent in the prorae wi e or own Proect or Chane. State tite o or preerred proect, the oectives and the reation to crrent wor.

Encosed description 12 paes

Enish certication does not have to e carried ot i an o the oowin is appicae:

Enish is other tone or ocia anae o the contr.

Enish is worin anae (pease encose stateent ro anaeent)

Carried ot hiher acadeic edcation (in 6 onths) where Enish was the edi o instrction (pease encose cop o certicate)

lANguAgE REquIREmENT

Position o appicant within or oranisation (preera shown in an oranisation chart, se a separate sheet o paper), as we as the position o or

oranisation within ESD processes in the contr.

Pease ive a short presentation o how or present wor reates to ESD.


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Nae o candidate

AbIlITy TO uNDERSTAND AbIlITy TO SPEAk

understands withot dict when Speas fent and accrate and is

addressed at nora rate easi inteiie

understands aost everthin, i Speas inteii, t is not fent

addressed sow and care or atoether accrate

Reires reent repetition and/or Speas hatin, and is oten at a osstransation o words and phrases or words and phrases

AbIlITy TO WRITE READINg AbIlITy AND COmPREHENSION

Writes with ease and accrac Reads fent, with coprehension

Writes sow and with on a oderate Reads sow, t nderstands aost everthin

deree o accrac

Writes with dict and aes reent Reads with dict, and on with

istaes reent recorse to a dictionar

lanae test adinistered : __________________________________________________________________________________________________

Tite: __________________________________________________________________________________________________

Address and Teephone: __________________________________________________________________________________________________

Date and sinatre: __________________________________________________________________________________________________

I o are seected, o wi e notied ax or e-ai. Please confrm your acceptance to attend by ax or e-mail.

Sinatre o Appicant

I certi that stateent in answer to the oreoin estions is tre, copete and correct to the est o nowede and eie.

I seected as a participant I ndertae to spend the tie drin the period o the prorae as directed the prorae anaeent.

Date ______________________________________ Sinatre o Appicant ____________________________________________________________

I do not have an inectios diseases (or exape tercosis or trachoa) or an other inesses which cod present riss to persons

that I wi coe in contact with.

I do not have an edica conditions which prevent e ro carrin ot trainin awa ro hoe.

I a in ood heath and enoin worin capacit.

Coent: ___________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________

mEDICAl STATEmENT

CERTIFICATE OF THE ENglISH lANguAgENot reired i an o the conditions at the otto o pae 3 app

Inormation to all applicants according to the Swedish Personal Data Act:

upon conration that or appication have een accepted, the persona inoration that or have iven in this appication wi e sed the

Prorae Oraniser in adinisterin the Prorae, yor persona data wi aso e avaiae to Sida or interna se. The data wi not e sed

or other prposes. I o want a record o ed persona inoration o st send a written reest to mr Toas Trn, ITP, SE-105 25 Stocho,

Sweden or [email protected]

257 esd-application 2011 web

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