Certificate Course PERSONAL INFORMATION. Family Name: Preferred Name for Communication Purposes: Date of Birth (MM/DD/YYYY): Nationality:

Similar documents
PHOTO CREDITS: SLUB Dresden/Deutsche Fotothek APPLICATIO N

Fellowship Program. ISN Programs. Practical Details for Applicant Fellows. ISN Programs Chair: John Feehally, UK

Joint Japan/World Bank Graduate Scholarship Program (JJ/WBGSP) APPLICATION GUIDELINES FOR 2016 JJ/WBGSP SCHOLARSHIP FOR JAPANESE NATIONALS*

INSTRUCTIONS FOR APPLICANTS

UC MEXUS Small Grants for UC Faculty

AIDS 2014: 20th International AIDS Conference July 2014 Melbourne, Australia INTERNATIONAL SCHOLARSHIP PROGRAMME: APPLICATION FORM

2017 Jeanne Raisler International Award for Midwifery

Fellowship Program. ISN Global Outreach (GO) Programs. Practical Details for Applicant Fellows. ISN GO Chair: Program Chair: Program Contact:

Program Application Guidelines

Application for Admission

Fellowship Program. ISN Programs. Practical Details for Applicant Fellows edition.

THE AMERICAN COLLEGE OF GASTROENTEROLOGY 2014 INTERNATIONAL GI TRAINING GRANTS PROGRAM

Fulbright U.S. Student Program

Fellowship Program. ISN Programs. Practical Details for Applicant Fellows edition.

PHOTO CREDITS: SLUB Dresden/Deutsche Fotothek APPLICATION FOR THE GEORG ARNHOLD INTERNATIONAL SUMMER SCHOOL ON EDUCATION FOR SUSTAINABLE PEACE

for the Georg Arnhold International Summer School on Education for Sustainable Peace 2014

PHOTO CREDITS: SLUB Dresden/Deutsche Fotothek APPLIϽATION FOR THE GEORG ARNHOLD INTERNATIONAL SUMMER SCHOOL ON EDUCATION FOR SUSTAINABLE PEACE

Dear Summer Camp Scholarship Applicant,

Joint Japan/World Bank Graduate Scholarship Program (JJ/WBGSP) Regular Program Application Form

CCAM Certified Control Account Manager Credential Certification Program Registration Form

OVPDEMA Study Abroad Scholarship

National University School of Health and Human Services Department of Nursing. Post-Graduate Advanced Practice Registered Nurse Certificate

A4LE SOUTHERN REGION FOUNDATION 2016 Scholarship Application Package

2018 APPLICATION ABOUT THE INTERNSHIP

Joint Japan/World Bank Graduate Scholarship Program (JJ/WBGSP) Regular Program Application Form

FAO Marshall Scholarships endorsement application form

A4LE SOUTHERN REGION SR ANNUAL CONFERENCE

2018 Spring JAXA International Top Young Fellowship (ITYF)

National University School of Health and Human Services Department of Nursing. Master of Science in Nursing. Admission Application

Nonresident Tuition Waiver Application

Blossom Hill Foundation Fellowship Application

The Director Telephone (91) (44) CICS Fax. (91) (44) , Gandhi Mandapam Road

S/1649/ July 2018 ENGLISH only NOTE BY THE TECHNICAL SECRETARIAT

Ruth Ann Widmeyer Nursing Scholarship WVU Medicine University Healthcare Foundation PURPOSE

Scholarship for Least Developed and Developing Countries

NOTE BY THE DIRECTOR-GENERAL

Dayton Power & Light and Vectren Energy Leadership Scholarship

Application for Accommodation 2018

Master in Anti-Corruption Studies 2018 Programme

LAII and Tinker Foundation Student Field Research Grants

UWA International Programs Scholarships

2018 Gleason/Kettel Summer Law Fellowship

Incoming Visiting Scholar Request Form

Application for Scholar-in-Residence Award in the United States

2018 Fellowship for Graduate Education Application

AY Scholar-in-Residence Program Otero Junior College

Application Guidelines for Exchange Students

N Ferno Performing Arts Center Scholarship Application

Master of China Studies

Completed applications must be received by February 1. No applications can be considered after this date.

Friends of the Israel Defense Forces National Rising Leaders Mission to Israel June 29 July 5, Application Form

Institute of Latin American Studies 2017 SUMMER FIELD RESEARCH PRE-DISSERTATION TRAVEL GRANT Application Form

arts education scholarship fund application

MINORITY HEALTH GLOBAL HEALTH

Request for Proposals (RFP) English Access Microscholarship Teacher Exchange

2017 ROTARY PEACE FELLOWSHIP APPLICATION DUE TO DISTRICT BY April

Candidate Application

Union College Bonner Leader Student Application

Course on. Environmental Economics for Development Policy (EEDP 8) Paris, France, July 18-29, 2005 APPLICATION FORM

DISTRICT GRANTS SCHOLARSHIPS BEST PRACTICES

SOCIETY CFA SCHOLARSHIP PROGRAM December 2006 and June 2007 Exams

Scholarship Program Guidelines

United States India Educational Foundation

Applications postmarked after Monday, April 16, 2018 will not be processed. Incomplete applications will not be accepted.

Families for Russian and Ukrainian Adoption (FRUA) Scholarship Program Application for Dina Brown High School Senior Scholarship

4. Do I need to be certified to practice medicine in the US? No, you do not need to be certified to practice medicine in the US to apply.

Touch Foundation s Application Form and Fundraising & Release Agreement for the 2017 TCS New York City Marathon on November 5, 2017

University of South Carolina School of Medicine / Palmetto Health Richland

APPLICATION FORM. Application deadline. Application for EM3E master admission with an Erasmus Mundus scholarship: December 15 th 2011 (mid-night CET)

PART I To Be Completed by Applicant

APPLICATION DEADLINE IS JUNE

Robert S. McNamara Fellowships Program

APPLICATION FORM

Graduate Application

2018 SUMMER STUDY ABROAD SCHOLARSHIP

!! PLEASE WRITE VERY CLEARLY TO AVOID PROCESSING DELAYS!!

Minnesota Farm Bureau Federation Young Farmers & Ranchers Excellence in Agriculture Award. Rules for 2018 MFBF Annual Convention Competition

Scholarship Application

ATHENA Scholarship Fund Windsor. Monday, April 30, 2018

2018 SYF Scholarship Application SYF Scholarship Application

PARTNER PROGRAM GUIDE

NABA Jacksonville SCHOLARSHIP PROGRAM

IRISH AID IRISH AID IDEAS PROGRAMME: STRAND II

UC Carbon Neutrality Initiative Application Research Fellowship

Schwarzman Scholarship Advising Timeline, Summer-Fall 2017 Advising and Submission Instructions: Please print and read this carefully.

2018 NSC Field School

An introduction to the workforce and a chance to explore one of the pre-identified work sites. Completed Explorer Program Application

Application Handbook

CEFPI SOUTHERN REGION FOUNDATION 2015 Scholarship Application Package

2016 Application. Timeline: 2016 Participants selected and notified

New Zealand. Regional Development Scholarships. Application Form

Fogarty Global Health Fellowships NORTHERN/PACIFIC GLOBAL HEALTH RESEARCH FELLOWS TRAINING CONSORTIUM

Thailand International Cooperation Agency Ministry of Foreign Affairs of Thailand FELLOWSHIP APPLICATION FORM

VISITING SCHOLARS PROGRAM FELLOWSHIP GUIDELINES Application Deadline: October 27, 2017

HBS-ACCION PROGRAM ON STRATEGIC LEADERSHIP IN INCLUSIVE FINANCE March 25-30, 2018 APPLICATION FOR ADMISSION

Educational Ambassadors Program

Middle Tennessee State University MSN Program. Clinical/Practicum Procedures

InWEnt Capacity Building International Germany. Health Division

2018 Application. Session 1: Who You Are and Leadership Session 2: Leadership Styles and the Purpose of Leadership

The Regulations for International Student Scholarship at I-Shou University

Transcription:

Certificate Course Sustainable Environmental Management July 12 August 2, 2019 Email application to beahrselp@berkeley.edu Applications due December 10, 2018 DIRECTIONS - Applicants who are having trouble using the online portal may fill out this application and email it to beahrselp@berkeley.edu by December 10 th, 2018 - Please attach a resume/cv and two signed letters of reccomendation with your application ELIGIBILITY - Proficiency in English to allow full participation in course discussions; - A resumé that demonstrates strong professional experience and leadership potential; - Affiliation with an institution concerned with environmental management/sustainable development. PERSONAL INFORMATION Given Name: Gender: Family Name: Preferred Name for Communication Purposes: Date of Birth (MM/DD/YYYY): Nationality: Email Address: Phone Number: Street Address: City: State: Zip Code: Country: Have you applied to the Beahrs Environmental Leadership Program before? No Yes If Yes: What years did you apply: Reasons for withdrawal (if applicable): EDUCATION: List your education history, beginning with the most recent. 1. Name of School: Major: Degree: Dates of Attendance: 2. Name of School: Major: Degree: Dates of Attendance: 3. Name of School: Major: Degree: Dates of Attendance: 1

EMPLOYMENT: List your employment history, beginning with the most recent. 1. Name of Organization: Position: Dates of Employment: Main Activities: 2. Name of Organization: Position: Dates of Employment: Main Activities: 3. Name of Organization: Position: Dates of Employment: Main Activities: For your current organization, please answer the following questions. 2

Type of Organization: National NGO International NGO Academic Governmental Intergovernmental Private Sector Other: In 2-3 bullet points, describe your organization s long-term mission or goals. In 4-5 bullet points, describe your organization s short-term objectives or projects you are currently working on. In 2-3 bullet points, describe challenges that you are facing in your current projects. PROFESSIONAL WORK Estimate your total years of experience in your professional discipline: 0-2 years 3-7 years Specialty (ex. Environmental Economics or Wildlife Management): Professional Development and Recognition History (i.e. training, awards, etc.): 8-14 years 15+ years PERSONAL STATEMENT As part of your application, please answer the following questions, limiting your responses to 250 words per questions for questions 1-3. 1. Describe your current work responsibilites. For what kinds of activities, operations and decisions are you directly responsible? 3

2. What are the two or three most important environmental issues or challenges that you are currently addressing in your work? What skills will you need to better manage these challenges? 3. What are your personal and professional goals for the future after completion of this program? What do you expect to gain by participating in the course? FINANCIAL INFORMATION Please initial to indicate that you need to be considered for scholarship review: 4

The course fee is US$8,000. This fee covers the costs of instruction, housing, most meals, course materials, field trips, and certificate. Participants are responsible for their own travel arrangements to and from UC Berkeley from their home country, and for covering approximately US$400 in additional meals and incidentals. Participants are also responsible for procuring short term medical insurance to cover the duration of the program. If you have questions or need assistance, please inquire. Each accepted applicant is responsible for seeking his/her own funding from government, employers, sponsors or other funding institutions to cover the course fees, visa, all travel expenses, and incidentals. If funding is confirmed at the point of application, attach a letter of support from the funding organization. Please initial to indicate that you have read the terms for the financial information section: A limited number of partial scholarships are available for qualified candidates. In the event that you receive a partial scholarship, you, your organization, or a sponsoring organization/donor will be responsible for paying the remainder of the course fees. Please answer the following questions to be considered for scholarship review. 1. What is your monthly and annual income in terms of $USD? 2. Beahrs ELP participants are expected to secure their own funding to attend the program. Please list two potential funding sources and the amount you expect them to cover. [Source 1; Amount 1], [Source 2; Amount 2] 3. Do you expect your organization to help cover the course fees? Y/N/Other: 4. The Beahrs Environmental Leadership Program attracts global environmental leaders to engage in unique sustainability approaches and dialogue. How have you demonstrated environmental leadership in your work? What kinds of projects do you work on that have illustrated your capacity as a leader, and why do you think this makes you a good candidate to receive a partial scholarship? [Limit to 300 words] 5. Describe your strategy for fundraising for this program. What organizations do you plan on contacting? Are there fellowships you plan on applying to? LETTER OF REFERENCE Provide the name, address, and phone number of a senior member of your organization from whom you are requesting a letter of reference. Letters should evaluate your professional work and highlight potential benefits from your participation in the course. We require 2 letters of reference to review your application. You are responsible for contacting your references and ensuring that they have submitted the signed letter via email to you or to the program at beahrselp@berkeley.edu. A copy of the 2 signed letters must be sent by email to beahrselp@berkeley.edu. Name of Reference 1: Title/Position: Email Address: Name of Reference 2: Title/Position: Email Address: 5

FINAL STEPS How did you learn about the Beahrs ELP at UC Berkeley? Check all that apply: Previous Participant Work/Employer ELP Website Email Other: Friend/Colleague Facebook Signature (sign here or attach a scan of your signature): Submit: Email application to beahrselp@berkeley.edu. Application packages must include ALL of the following to be reviewed: 1. Signed application answering ALL questions 2. 2 Signed Reference Letters, emailed to beahrselp@berkeley.edu by December 10, 2018 3. Resume or Curriculum Vitae The 2019 Beahrs ELP application has three scholarship review periods. Please submit your application by October 20th, 2018 to be considered for the first round of scholarship review or November 17th, 2018 for the second round of scholarship review. Those who submit their application for the final deadline of December 10th will also be reviewed for scholarship; however, we cannot guarantee that there will be any remaining funds available for those who apply after November 17th, 2018. The final due date for the 2019 Beahrs ELP application is Monday, December 10th, 2018. Please submit all application materials (application form, CV/resume, 2 letters of rec) by this due date to be considered for admission to the program. Materials submitted after this date will not be reviewed. We strongly encourage applicants to submit their application materials as soon as possible in order to have extra time to apply for outside funding and visas. 6