WH Application Form and reference.pdf

7/25/2019 WH Application Form and reference.pdf

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Wide Horizons (WH)Application Form

Test Location: ______________ Test Date: ________________(Date/Month/Year)

Please complete the form and submit to WH staff member on the day of testing.If

you need an application, please email [email protected]

1. Personal Information

Name:

Date of Birth:_______________ Gender (circle 1): Male / Female / Other_____

Ethnicity:

Marital Status:

Phone Number:

Email:

Host Organization:

2. Documentation

Please circle the following identification category that applies to you and attach a copy

of the ID card/document to this application. (Note: You can apply without identification)

a) UNHCR

b) PRE-registration

c) 10 year ID

d) Other

3. What is the highesteducation level that you have completed?

(Note: You can still apply if you have not had formal education)

a) Primary b) High School c) Post-Ten d) University e) Other _______________

4. Burmese Language skills

I can (circle all that apply) speak Burmese / write in Burmese / read Burmese

How would you rate your Burmese Language skills? Please circle one.

a) Advanced b) Very good c) Good d) Basic e) Weak

5. Volunteer, Work, or CBO Experience: Please provide detailed information ofyour present andpast work/volunteer experience in your community.

CurrentOrganization

Start Date

End Date

Job Title

Descriptionof Duties

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5. Volunteer or Work Experience Continued:

Past

Organization

Start Date End Date

Job Title

Description

of Duties

6. Why are you applying for Wide Horizons School?

What are your plans after your 1-year internship with your host organization?

7. Reference

Please give the attached reference form to your supervisorat your

currentorganization to complete about you. *Note: You cannot give this

form to a parent, family member, or friend.

* ()

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Wide Horizons (WH)

REFERENCE FORM (page 1)

)

Candidate name:

_____________________________________________

Referee name/ Title :

_____________________________________________

Organization:

______________________________________________

Contact Details: ______________________________________________

Please complete the following grid for this candidate.

Excellent

Good

Average

Below average

Motivation to learn new things

Critical Questioning Ability

Communication skills Leadership Potential

Management (time, tasks)

Persistence

Self-motivation

Atitude and Enthusiasm

Team work

Interest in community work

Commitment to Organization

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REFERENCE FORM (page 2)

)

Please comment about the candid ate in detai l :

Length of time working at organization: __________________________

Current responsibilities at organization: ( )

Strengths: ( )

Weaknesses: ( )

What I hope the candidate will learn at WH:

WH

Intended responsibilities during internship year(

)

I _________________________ (your name), declare that I am the supervisor of

__________________________ (candidate name), that our organization is willing forthe candidate to attend WH for 10 months, and that we intend to have a job ready forthe candidate when s/he returns for his/her internship at our organization in April.

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/___________________________ ()

/ ________________________ ()

/ WH

( )

Signature ():______________________ Date( ): ____________________

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WH Application Form and reference.pdf

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Transcript of WH Application Form and reference.pdf