Self-financed participation

Www.preparinggloballeaders.com

APPLICATION FORM

A completed registration form (see below) is necessary to register and be considered for participation in the Preparing Global Leader Summit (PGLS). Please, fill the form out in English, including the titles and names of the programs you have completed/participated in. A confirmation letter will be sent to the applicant by e-mail upon the acceptance of your application. Admission decision letters will be sent to all accepted applicants via e-mail by July 4. Category B applicants submitting their applications until July 15 will be accepted on a rolling basis, and will, therefore, receive their admission decision letters by July 17. Please note that incomplete applications will not be accepted. The PGLS can grant refunds should an admitted applicant decide against participation due to the unforeseen circumstances. However, refunds will only be granted if a cancellation and refund request are received by July 10, 2014. Should you need more information, do not hesitate to contact the program administration board via e-mail at apply@preparinggloballeaders.com.

Application type:
Category A	Category B

*Category A: applicants who hold a citizenship of a country that needs VISA to enter Russia.

*Category B: applicants who hold a citizenship of a country that does not need VISA to enter Russia.

(Please type)

PERSONAL DATA

Family Name:		Date of Birth:	MM.DD.YYYY
First Name:		Country of Birth:
Gender:	M / F	Country of Citizenship:

1.ADDRESSES

A. Home Address

Home Address:	Line1	Zip code:
Home Address 2:	Line2	Phone:
City / State		Email:

Work address (if applicable)

Work Address:	Line1	Zip code:
Work Address 2:	Line2	Phone:
City / State		Email:

2.ACADEMIC / PROFESSIONAL INFORMATION

(please list only the most relevant academic / professional experience starting with the most recent one; upload your CV in .pdf format for further information)

A. EDUCATION

University / Institution:
Year of Study and the Name of the Program:
Start date:
Graduation Date (if applicable):
Country:
Have you previously attended another University:	Yes: No:
If “yes” please list:
University Name
Name of the Program:
Dates Attended:

(*copy/paste should you wish to add more information)

B. PROFESSIONAL EXPERIENCE

Organization/Company:
Start date:
End date:
Official Position:
Country of Operations:

(*copy/paste should you wish to add more information)

C. OTHER

Have you applied to PGLS before?	Yes: No: *If “yes” please specify which year:
Have you already attended other leadership schools of the Preparing Global Leadership Foundation? (e.g. PGLI, PGLA, GLP etc.)	Yes: No: *If “yes” please specify which leadership school:

3. ENGLISH LEVEL COMPETENCE

PLEASE NOTE that PGLS is taught entirely in English. Therefore, a satisfactory competence in theEnglish Language is essential for the participation and the successful completion of the program.

Please state your level of knowledge of the English language
Basic	Intermediate	Advanced	Mother tongue

PASSPORT INFORMATION

PLEASE NOTE: The following Passport Information is required for all applicants with a valid passport. Please make sure that your passport does not expire before the end of the Summit. If you are in the process of applying for or renewing your passport, leave this section blank and email to apply@preparinggloballeaders.com (with the subject line PASSPORT INFORMATION) the following information when the new passport becomes available:

Do you have a valid passport?	Yes: No:
Country Issuing Passport:
Passport Number:
Passport Issuance Date:
Passport Expiration Date:
Full name (must be written as it appears in your passport):

ADDITIONAL INFORMATION

Do you have special physical or medical needs?
Give us details of someone we can contact in case of emergency while you are at PGLS (name, phone number, contact address, email address)

MOTIVATION

Briefly indicate the motivation for participation at Preparing Global Leaders Summit and what you would like to gain by attending it. Please also identify a pressing problem in your country and elaborate on how you aspire to overcome it as a future leader (max. 300 words):

How did you find out about this program?

Name the source (institution, person, internet resource, etc.)

PROGRAM COST AND SCHOLARSHIPS

The program cost is 1200 USD.

Tuition, study materials, housing, daily breakfast and lunch, two formal dinners, and visa support (invitation letter) is included in the cost of the program. Participants are expected to fund their travel and visa costs on their own.

A limited number of partial scholarships for the program tuition are offered on a competitive basis. Should you wish to apply for a scholarship, please refer to Section 9. If not, please check the box below:

Self-financed participation

SCHOLARSHIP APPLICATION

Instructions: This section applies to all participants who wish to apply for a scholarship. Scholarships are awarded based on a combination of financial need and merit. Awards are made on a rolling basis in conjunction with admission to the program, with earlier applicants receiving priority consideration. Students are responsible for finding additional sources to cover the full tuition in case partial scholarships have been awarded. Please note that upon admission to the program, PGLS is going to supply you with a support letter you can forward to potential sponsors (local NGOs, public institutions, political parties, embassies and consular representations, international funds etc.).

Would you like to apply for the scholarship funding?	Yes: No:
How much funding are you applying for from PGLS?

SCHOLARSHIP STATEMENT

Please write a brief statement describing your need for a scholarship (max. 200 words):

Priority deadline is May 26, 2014. Applicants in need of scholarship support are urged to apply before the priority deadline. While scholarship support is available after the early deadline, it is allocated on a rolling basis and earlier applications are given priority. Final deadline for Category A applicants is July 1, 2014. Category B entries will be received until July 15, 2014.

Please, send the following documents to apply@preparinggloballeaders.com (subject line: PGLS 2014 Application Form):

· A completed application form (incomplete aplications will not be accepted)

· CV (resume) in .pdf format

· Other relevant document (language test scores, diatary restrictions, etc.)

Date: 2016-01-03; view: 719

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