Application for Civic Empowerment and Social Movements course

State qualifications; year(s) and name(s) of institution(s) you qualified.

Describe your present responsibilities/activities.

State your most recent work experience relevant to this application:

What areas/concepts of your interest (within the course programme) would you like to concentrate on? Indicate in order of preference.

Do you have any special needs? State only those which will have an influence on your participation in the course, e.g. diet, disabilities etc.

Is your spouse and/or any children accompanying you? If yes, state spouse’s name. Spouse attending a course should fill-in a separate application form. Spouse not attending a course pay for accommodation and meals only. Also state name(s), age(s) of chid(ren) and languages spoken.