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Fellowship :
Youth Fellowship in June 2016 Global Peace on the Move 18
Venue :
Mooktawan
Date :
16th - 29th June 2016
Required Self-development Days:
42 days
Required Special Ops:
2
Application Deadline:
28th February 2016 (in 29 days)
Eligibility Deadline:
11th April 2016 (in 72 days)
What is your motivation of joining this activity? What do you expect from the fellowship?:
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Proposal:
Venue:
Contact Information
Name:
GAby
Middle name
Yepes
Your name is only available to the Peace Revolution Crew and your Peace Coaches.
Other name:
Other names you are known by or have ever been known by
Gender
Male
Female
Date of birth
1975-12-13
Nationality
Nationality
Country of birth:
Peru
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Present country:
Peru
Home phone:
Mobile phone:
Skype address:
Please enter a Skype address as it is needed for an interview process and Online Special Ops.
Facebook:
https://www.facebook.com/app_scoped_user_id/10153547005952961/
Upload Files
Please provide a portrait photo of yours. This photo will not replace the display photo you are using. It will only be used by the interviewing process
and will not be displayed publicly on the Peace Revolution website. Click here (//cloud.peacerevolution.net/img/page-apply-for-agency/portraitphoto-example.jpg) for an example of the photo we want. The photographs must be less than six months old.
No
Issuing Country:
Country
Passport Number:
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Do you have another passport?:
Yes
ApplyfortheAgency| PeaceRevolution
No
Have you travelled abroad within the past two years? If so, for what purpose (business, pleasure)? Do you travel alone or with
friends/family?:
Education
Education:
Please choose your highest level of education.
Faculty:
Major:
Minor:
Name of college/university:
Country:
Country
Graduated
Studying
Year of graduation:
School:
Country:
Country
Work/Professional Experience
Name of organization/ affiliation/ company:
Type of organization:
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Title/Position:
Type:
Full-time
Part-time
Volunteer
Describe your duties in details (knowledge, skills, abilities required, employees supervised and accomplishments):
to year
Company Website:
Separated
Do you have a partner (or a friend) who also applies for the fellowship?:
Native language:
Religion:
your family:
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Health
Have you ever been seriously or contracted with contagious disease?:
Yes
No
Do you have any medical condition that requires, or may require, one of the followings during your stay in Thailand
Renal dialysis:
Yes
No
Hospital care:
Yes
No
Residential care:
Yes
No
Residential care is long-term care provided in live-in facilities for the aged or for people with physical, sensory, intellectual, or psychiatric
disabilities.
Have you ever used any medication or drug in the past 2 years?:
Yes
No
Your Character
Have you been:
convicted:
Yes
No
charged:
Yes
No
under investigation:
Yes
No
for any offence(s) against the law in any country, including Thailand
Have you been:
excluded (refused entry) from:
Yes
No
No
removed or deported:
Yes
No
Additional Questions
Have you ever practiced Meditation/Observation of Silence before? If yes, regularly? What was the meditation technique? :
Your answer:
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What is your ticket price? Please state your departure and arrival destination.:
Your answer:
We provide partial to full sponsorship of airfare and accommodation. Please write a brief statement telling us why you will need
sponsorship, how you can contribute to the project, and how will your participation give benefits to your society?::
Your answer:
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