Professional Development Grant

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1 Professional Development Grant Please regularly save your application by clicking the "save and continue" button at the bottom of this application. Grant Overview Professional Development Grants (PDG) provide support for mid-career conservationists to pursue short-term, non-degree training to upgrade their knowledge and skills through short courses, workshops, symposiums, conferences, and professional exchanges. The guidelines and eligibility criteria for this opportunity are available at I. Personal Information Your full name as it appears on your bank account: Title: Given name: Surname: Dr Mr Mrs Ms Miss Gender: Male Female Date of birth (MM/YYYY): Nationality: Belize Bhutan Bolivia Cambodia Central African Republic Colombia Congo, Democratic Republic Ecuador Fiji French Guiana additional choices hidden... Papua New Guinea Paraguay Peru Republic of Congo Solomon Islands Suriname Uganda Vietnam Zambia Cameroon Do you hold dual nationality? Yes

2 Please select your other nationality: Afghanistan Albania Algeria Andorra Angola Antarctica Antigua and Barbuda Argentina Armenia Australia additional choices hidden... United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela Vietnam Yemen Zambia Zimbabwe Do you live in a country other than your home country? Yes Please select your country of residence: Afghanistan Albania Algeria Andorra Angola Antarctica Antigua and Barbuda Argentina Armenia Australia additional choices hidden... United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela Vietnam Yemen Zambia Zimbabwe Do you self identify as part of an indigenous group? Yes What is the name of the indigenous group? Native language(s): Please rate your ability to speak in English: Poor Fair Good Excellent

3 Please rate your ability to write in English: Poor Fair Good Excellent Contact Information Please provide an alternate address: Skype ID: Address where you wish to be contacted: Home Work Street address: City: State/province: Postal code: Country: Employment Information Do you currently work in your home country? Yes Please explain: How many years of paid work experience do you have in the field of conservation? Current Employment Please provide your current or most recent place of employment: Organization name: Organization address:

4 Country: Type of organization? Current job title: Current job level: Is your position full-time, part-time, or voluntary? When did you begin working at this organization? Please describe your job responsibilities: If you are a manager, how many staff members do you manage? Belize Bhutan Bolivia Cambodia Cameroon Central African Republic Colombia Congo, Democratic Republic Ecuador Fiji additional choices hidden... Nepal Papua New Guinea Paraguay Peru Republic of Congo Solomon Islands Suriname Uganda Vietnam Zambia Academic institution Governmental n-governmental organization (local) n-governmental organization (international) For-profit Entry-level Mid-level Senior-level Director/manager Senior management Full time-paid Part time- paid Full time- unpaid Part time- unpaid Voluntary Do you work in a protected area? Yes Please list the protected area: Please describe the most recent conservation project/research you have worked on: Date (year) of most recent conservation project: Previous Work Experience List your previous work experience, starting with your most recent positions. How many previous employers would you like to list? 1 2

5 3 Employer 1: Organization name: Position held/job title: This position was: Paid Unpaid/Volunteer Employer 2: Organization name: Position held/job title: This postion was: Paid Unpaid/Voluntary Employer 3: Organization name: Position held/job title: This position was: Paid Unpaid/Voluntary Accomplishments Please list your most significant accomplishments, awards, publications, and other achievements relevant to your application. How many would you like to list? Accomplishment 1: Web link 1: Accomplishment 2: Web link 2: Accomplishment 3: Web link 3: Accomplishment 4:

6 Web link 4: Accomplishment 5: Web link 5: Educational Qualifications Professional Development Grant applicants are not required to have any minimum level of education to be considered eligible for the grant. Please note, current students (undergraduate and graduate) are not eligible for funding. Are you currently enrolled in an academic program? Yes Previous Education Experience List your previous educational experiences, starting with the most recent. How many would you like to list? Educational experience 1 Institution: Degree: Major: Educational experience 2 Institution: Degree: Major: Educational experience 3 Institution: Degree: Major:

7 Please select the activity that you are requesting EFN support for: Course or Training Conference Course or Training Full title of proposed training course: Host institution: Course or training location: Course contact name: Course contact Course website: Additional Information - Course or Training Have you been accepted to this course or training? Yes Do you need a visa to attend this course or training? Yes Will you be presenting at the course or training? Yes Type of presentation: How will attending this course or training help you achieve your career goals? Be specific. How will you apply what you learned during the course/training to your current work to address conservation challenges in your home country? Be specific. Oral Poster Other Conference Full title of proposed conference proposed: Host institution: Conference location: Conference contact name: Conference contact Conference website:

8 Additional Information - Conference Have you registered for this conference? Yes Do you need a visa to attend this conference? Yes Are you presenting at the proposed conference? Yes Type of presentation: How will attending this conference help you achieve your career goals? Be specific. How will you apply what you learned during the proposed conference to your current work to address conservation challenges in your home country? Be specific. Oral Poster Other If you are presenting, please upload the following: Your presentation abstract: A copy of your presentation acceptance letter Visa Upload If you have a visa to attend this course or conference, please attach a copy: How did you hear about this course or conference? EFN's Facebook page Former EFN grantee WWF employee Listserve (please specify) Website (please specify) Budget Information Please take your time completing the budget information section. All information should be accurate. Do you have a bank account in your name? Yes Name on account: What is the total cost of your program (in US$)? Do you have other funding to help cover your costs? Yes Please list the other funding sources below. Please indicate what expenses the funds will cover (ex. airfare).

9 Source (1): Amount (US$): Is this amount secured? Yes Expenses these funds will cover: Source (2): Amount (US$): Is this amount secured? Yes Expenses these funds will cover: Source (3): Amount (US$): Is this amount secured? Yes Expenses these funds will cover: Additional Funding Upload Please upload an official document showing you have been approved for additional funding. Budget Details Please indicate the exact amount you are requesting, for each line item, from EFN in US Dollars. Insert NUMBERS only. Do not include any special characters (.,$, etc.). Tuition & Fees Tuition (US$): Other required fees (US$): Explanation of other required fees: Living Expenses Accommodations (US$): Food (US$): Travel Expenses Airfare (US$): Ground transportation to travel to and from academic program (US$): Books and Materials Books and Materials (US$) Other Expenses Other (US$): Other (explain):

10 This field populates automatically. Total amount (US$): ({{ TF[0] + TF[1] + LE[0] + LE[1] + TE[0] + TE[1] + BM[0] + OE[0] }}) What is the latest date by which you need to receive funding? / / (YYYY/MM/DD) Relationship to WWF What is your current relationship to WWF? (Select all that apply): Current employee Former employee Current consultant Former consultant Work at a WWF partner organization Seconded to WWF from a government agency or other organization Volunteer Relative of an employee Friend of an employee t affiliated with WWF Other Relationship to EFN Have you received EFN funding in the past? Yes What type of grant(s) did you receive? Russell E. Train Fellowship/Scholarship EFN Professional Development Grant EFN Conservation Workshop Grant EFN Reforestation Grant EFN Alumni Grant In what year(s) did you receive funding from EFN? How did you hear about EFN? WWF office Partner organization EFN alumnus/grantee Website Other

11 Terms of Agreement If I receive a WWF Education for Nature Professional Development Grant, I agree to: Inform WWF-EFN about any changes to my eligibility status. Successfully complete the proposed activity. If I do not successfully complete the proposed activity, or I if I engage in conduct that is unbecoming of a grantee, I understand that WWF-EFN retains the right to end the contract and stop all payments without prior notice. Return to my home country immediately following the proposed activity. Submit all required reports on time, as indicated in the grant agreement. Provide regular updates to EFN about my professional progress during and after my EFN supported activity. Allow EFN and WWF to publish my name in related publications and websites. Confirmation I confirm that all the information in this application is true to the best of my knowledge and I agree to all terms of the Applicant Agreement.

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