7th SCHOOL OF PEACE STUDIES & CONFLICT TRANSFORMATION

February18 March 10, 2012 Penang, MALAYSIA Bangkok and Pattani, THAILAND

Application Instructions
Who can apply Peace and development workers from NGOs and faith based organizations, peace and human rights activists, youth leaders, researchers, journalists, young scholars and development professionals who are active in peace studies or peace building programs. Preference is shown for applicants who can demonstrate how this course will directly benefit their organization or academic institution in developing or peace programs at local, regional and/or international level. Proficiency in English is required. If you are accepted you will be required to participate in academic lectures, discussions and role plays in English. Please do not apply if you do not have strong English skills. Previous course participants are not eligible to apply. How to apply By 5 December 2011, send completed application form, resume/CV, statement on Peace, two letters of recommendations and passport photo to: International Institute of Peace Studies c/o Asian Muslim Action Network House 1562/113, Soi 1/1 Mooban Pibul, Pracharaj Road, Bangkok 10800, Thailand Tel: 66-2-9130196 Fax No.: 66-2-9130197 E-mail: peacestudies@arf-asia.org

This form may be submitted by fax or e-mail. Applications will be acknowledged on receipt. Applicants will be notified of the outcome of selection soon after the closing date. No application or request for financial support will be considered until all application materials are complete.

Registration and Course Fee Course fee is $ 200 US (food, accommodation, transportation within Thailand and Malaysia and international travel between the two countries, materials and training fee will be offered to the successful candidates). Participants are responsible for round-trip travel cost from home country to Penang, Malaysia and from Bangkok, Thailand to home country. Participants are expected to seek financial support from their organization and other foundations.

APPLICATION CLOSE DATE: 5 December 2011

Application Form
Please do not include any information that you think might affect your safety and security

I - PERSONAL INFORMATION
1. Family Name: 3. First Name: 5. Male / Female: 7. Age: 2. Middle Name: 4. Nick Name / name you want to be called: 6. Date of Birth: 8. Place of Birth:

9. What religious tradition (if any) do you identify with? 10. Do you identify as an Indigenous person / member of an ethnic minority? Y/N If yes, please specify.

II CONTACT DETAILS
11. Postal Address - Number/Street: 12. City: 14. Country: 13. State/Province: 15. Postal Code:

16. Phone Number 1: (including country code): 17. Phone Number 2: (including country code): 18. Fax number: (including country code): 19. Email Address: 20. Alternative email address:

III PASSPORT DETAILS

21. Passport Number: 23. Country of Birth: 25. Issue Date: 22. Citizenship: 24. Country Issuing Passport: 26. Expiration Date:

IV - ORGANIZATIONAL INFORMATION & WORK EXPERIENCE

27. Name of organization / cause you work for: 28. Current Position (include specific job responsibilities):

29. Write a short summary of your role and other practical experience you have had regarding peace issues / concerns: 30. Outline the reasons why you would like to participate in the 6th School of Peace Studies and Conflict Transformation. Please explain how this course relates specifically to your work or situation and how you might apply the learnings from the course in your work in the future. 31. Please briefly describe a project, campaign or issue on which you are working on or have worked on that you think is relevant to this program and that you will be willing to share information about with other participants during the program.

V EDUCATIONAL BACKGROUND 32. Degrees / courses successfully completed: (Please list all colleges, universities, and professional schools attended, beginning with most recent. Include degrees or certificates earned, dates attended.) Please attach CV or Resume. 33. Other training, including previous PEACE training: (Please give details)

VI - LANGUAGE
If you are accepted you will be required to participate in academic lectures, discussions and role plays in English. Please do not apply if you do not have strong English skills. 34. Is English your mother tongue? YES ( ) or NO ( ) If your mother tongue is not English, please answer all the following questions as fully as possible. 35. How have you learnt English? 36. How often do you use English and where do you use it? 37. Rate your English ability using the scale: 1=fair, 2=good, 3=excellent Spoken English: ______ Written English: _______ Comprehension: _________

VII - REFERENCE LETTERS (

Enclosed or

Sent separately )

Please include 2 letters of recommendation from your referees. One reference should be from the head of your organization or immediate work supervisor. Letters should be a maximum of one page in length. Please ask your references to address the following questions: 1) What is the role of the applicant in their organization? 2) Will the applicants participation in this program impact positively on his/her work? 3) Why do you feel this candidate will benefit from School of Peace Studies and Conflict

Transformation program? 4) Please confirm English proficiency of applicant. 5) Please include any other information you think is relevant. Reference 1 (details) Name: Organization: Relationship: Email: Fax (including country / district area codes): Phone (including country / district area codes):
AMAN Affiliation (if any):

Reference 2 (details) Name: Organization: Relationship: Email: Fax (including country / district area codes): Phone (including country / district area codes):
AMAN Affiliation (if any):

38. How did you hear about this training?

VIII - SPONSORSHIP
You will need to consider whom to approach to sponsor your travel expenses and the course fee of $ 200 US (which subsidizes food, accommodation, materials and training fee). 39. Do you have funding for your course fee and travel expenses?

40. AMAN will sponsor a limited number of applicants for this program. Would you like to be considered for sponsorship? (if yes, please give reason for need) : 41. Travel Cost: Round trip travel costs from my city of residence to Bangkok, Thailand is approximately ___________? (Please give figures in US dollars for most affordable fare) IX - TRAVEL INSURANCE All participants must have their own travel insurance for both Thailand and Malaysia. The cost of medical care in Bangkok and Malaysia is extremely expensive. In the past we have had participants who have been sick and have had to go to hospital; this has cost them more than 10,000 Thai Baht or 1,000 Malaysian Ringgit. If you do not have travel insurance then you are not able to attend the program. Name of Insurance Company:_______________Policy number:____________________ X - EMERGENCY CONTACT INFORMATION

Name Relationship Mailing Address Tel./Fax E-mail Occupation Position Organization XI - CONSENT
42. Do you give us consent to use the information provided in this form to write a short biographical paragraph about you that will be given to trainers, participants and others for the purposes of informing them, seeking funding on your behalf, advertising this training and in future School of Peace Studies publicity material? YES NO 43. Do you have concerns about your personal security that we should consider before using the information you have provided here? YES NO

XII - WRITTEN STATEMENT

44. Please write a statement on Peace and diversity in your local area or country, highlighting your knowledge of local peace and conflict issues. The statement should also answer: - Where do you see the biggest challenges in promoting peace in your community/country? - Where do you see the greatest opportunities for promoting peace in your community/country? (one to two typed single pages, maximum 1000 words) Essay is Enclosed or Sent separately

XIII - SIGNATURE AND PHOTOGRAPH 45. I certify that the information I have provided on this application form and in any attached materials is true and complete. Full signature ________________________________ Date: __________________

Please attach passport photograph

Date completed: _________________

APPLICATION CHECKLIST Before submitting the application, please make sure you have included: ___ Passport photo ___ Two letters of reference ___ Statement on peace and diversity ___ Curriculum vitae or resume ___ Proof of travel health insurance ___ Signature and date Incomplete applications will not be considered.