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ЗАЯВКА (JOHN SMITH FELLOWSHIP PROGRAMME 2007 APPLICATION FORM)

 

06.09.2006

 

   JOHN SMITH FELLOWSHIP PROGRAMME 2007 APPLICATION FORM

   The John Smith Memorial Trust is working to promote equal
   opportunities in and through its Fellowship Programme. The aim of our
   policy is to ensure that all those who come into contact with the
   Trust or the Fellowship Programme receive equal treatment across
   ethnic or national origins, religion, gender, marital status,
   disability, sexual orientation, age or class, and are not
   disadvantaged by conditions or requirements that cannot be shown to be
      justified.

   Please complete all parts of this form in typescript as a digital file
   to  be emailed by November 7^th 2006 to the British Council. A printed
   copy, with your original signatures and photograph, is also required. 

   PART A: PERSONAL DETAILS

   Family name:

   (as in passport)

   Other names:

   Mr Mrs Miss Ms Dr Male Female

   Title: Sex:

   Date of birth:

   Nationality:

   (as in passport)

   PLEASE NOTE: If your application is successful the photograph attached
   here  may be used by the John Smith Memorial Trust and British Council
   in Fellowship Programme literature.

   How  did you first hear of the John Smith Fellowship Programme? Please
   give  details  of  any  advertisements,  press reports, websites, etc.
   Please mention other sources you have used for information, too.

   Languages spoken:

   Foreign  languages  spoken  (please  state  proficiency level and list
   languages spoken):

   Address for correspondence in home country:

   Telephone number:

      Email address:

   Name  and  address of next of kin or person in your country who should
   be  contacted  in the event of an emergency (please state relationship
   to you):

   Telephone number:

      Email address:

   Do  you  have  any  special  requirements,  i.e.  mobility, religious,
   dietary,  health,  or  related  to a disability? If so, please provide
   details:

   Languages spoken:

   Foreign  languages  spoken  (please  circle proficiency level and list
   languages spoken):

   Under  the  John  Smith Fellowship Programme, we cannot pay married or
   child  allowances;  any  allowances  you receive are intended to cover
   your  expenses only. If any members of your family intend to accompany
   you to the UK you will have to meet their costs yourself.

   PART B: ACADEMIC BACKGROUND 

   Please list all academic qualifications obtained since completing your
   secondary  education,  stating  the institutions attended and when the
   main  courses  started  and finished. Please indicate with an asterisk
   (*) those courses where the language of instruction or supervision was
   entirely or mainly English:

                               Qualifications

                            (including class or level)

                                Institution

                                  Subject

                                    From

                                     To

   Computing/IT skills (please describe)?

   PART C: PROFESSIONAL BACKGROUND

   Please  list  all  positions  held  since  completing  your university
   education, stating your job title. This should include paid employment
   and, if relevant, any voluntary activities.

                                     Position

                             Organisation/Institution

                                    From

                                     To

   PLEASE RESPOND TO THESE QUESTIONS USING A MAXIMUM OF 300 WORDS. LONGER
   ANSWERS MAY NOT BE CONSIDERED.

   Who is your current employer? If you work in the public sector, please
   tell  us  what  department  you  work in and describe briefly its role
   within  the  wider organisation. If your employer is an NGO or private
   sector  organisation,  please enclose details of the organisation with
   this  application,  including  the  number  of  paid  staff.  If  your
   organisation  relies  on  volunteers, how many are active in its work?
   Please respond in no more than 300 words.

   What  is  your current job? Please describe your main responsibilities
   including  areas  of policy covered, and the number of people who work
   for  you  or  under your supervision, if applicable, and where you fit
   within  your  organisation.  Tell us how your job relates, directly or
   indirectly,  to  one  or  more  of the following: good governance, the
   improvement of human rights or public services, media reform, economic
   reform,   political   reform,   or   the   provision  of  support  for
   disadvantaged groups. Please respond in no more than 300 words.

   PART D: OTHER INTERNATIONAL EXPERIENCE

   Have  you  ever  visited the UK before? If so, please indicate when it
   was, your length of stay, and the purpose of your visit:

                                      Dates

                                     Purpose

   Have  you  ever  lived, worked or participated in scholarships outside
   your  home country? If so, please indicate when it was, your length of
   stay, and the purpose of your visit:

                                      Dates

                                     Purpose

   PART E: PROGRAMME OBJECTIVES

   Please state in the space provided below

    a. What do you understand about the nature and aims of the John Smith
       Fellowship  Programme and what is expected of participants? Please
       respond in your own words and using no more than 300 words.

   PLEASE RESPOND TO THESE QUESTIONS USING A MAXIMUM OF 300 WORDS. LONGER
   ANSWERS MAY NOT BE CONSIDERED.

    b. Why  you  wish  to  undertake the Fellowship? Please respond in no
       more than 300 words.

    c. What  are  the  main subjects you would like to explore during the
       Fellowship  and what are the main areas of UK Governance you would
       like to learn about? Please respond in no more than 300 words.

   PLEASE RESPOND TO THESE QUESTIONS USING A MAXIMUM OF 300 WORDS. LONGER
   ANSWERS MAY NOT BE CONSIDERED.

    d. How  do  you intend to use what you learn during the Fellowship to
       influence  one  or  more  of  the  following  areas,  directly  or
       indirectly, on your return: the provision of public services; good
       governance;  the  improvement of support for disadvantaged groups;
       media  reform;  good economic management; the improvement of human
       rights? Please respond in no more than 300 words.

   PART F: ATTACHMENTS PROGRAMME

   Before   completing   this  section,  please  refer  to  the  note  on
   attachments which accompanies this form.

   The  Fellowship  includes a two-week individual work attachment, which
   should  complement  the  experience  and  interests  of  each  fellow.
   Previous   placements  have  involved  government  departments,  NGOs,
   academic institutions, research organisations, trade unions, political
   parties  and  the media. Please outline the nature of the organisation
   you  wish  to  work with and briefly describe your aims and the issues
   you  wish  to  cover.  If  you  have  an  interest  in  any particular
   organisations in the UK, please provide details:

   DATA PROTECTION: YOUR PERSONAL INFORMATION

   The British Council will use the information completed by you as part
   of the selection process for the granting of a John Smith Fellowship,
   according to the criteria set by the Department for Constitutional
   Affairs (DCA) and the John Smith Memorial Trust (JSMT). If selection
   is successful your information will be used to set up and administer a
   programme designed to meet your needs. It will also be used to
   evaluate and report on the outcome of your programme. Evaluation will
   include follow-up contact with you by the British Council and John
   Smith Memorial Trust after you have returned home.

   Your information will be used within the British Council for these
   purposes only, and will also be disclosed to the Department for
   Constitutional Affairs, the John Smith Memorial Trust and the
   institutions and organisations which you will visit in the UK, for the
   same purpose only. Your photograph is required for the purpose of
   identification, but if your application is successful, it may also be
   used on the John Smith Memorial Trust website or in other Programme
   literature. Your name and the dates of your visit will be passed onto
   an insurance company for the purpose of medical insurance to cover
   your stay in the UK.

   If you have provided details of special requirements i.e. mobility,
   religious, dietary or disability requirements, this will be used by
   the British Council to provide for them. By returning this form to us
   you consent to our processing this sensitive personal data about you
   where this is necessary for this purpose.

   Under the 1998 Data Protection Act you have a right to ask for a copy
   of the information we hold on you, for which we will charge a fee.
   Contact the Data Protection Officer by email at
   dataprotection@britishcouncil.org or send in your request to the Data
   Protection Officer, The British Council, 10 Spring Gardens, London
   SW1A 2BN. If you feel that the information we hold about you is
      inaccurate please contact the British Council.

   I, the undersigned, have read and agree to the above provisions:

   Signature: Date:

   You   must   provide  the  following  documentation  along  with  this
   application form (please tick): 

     * A recent passport-sized photograph (in colour)

     * Photocopies   of   academic   certificates  (and  translations  if
       relevant)

     * Letters  from  two  referees,  of  which  at  least  one should be
       professional.  Please  note  that  all references for short listed
       candidates  are  checked  by  the  British  Council,  so  you must
       provide contact details for each referee.

     * Information  about  your  employer  as requested in Part C of this
       application (if relevant).

   S

   8

                                 Photograph

   First heard about Fellowships through:

   Other sources of information used:

   DECLARATION: PERSONAL RESPONSIBILITY AND ETHICS

   The  John  Smith  Fellowship  Programme  is  inspired by principles of
   tolerance,  respect,  gender  equality  and  ethical behaviour. I, the
   undersigned,  declare  that  if  offered  a  place  on  the John Smith
   Fellowship  Programme,  I  will seek to promote these principles in my
   own interactions with other Fellows and with the many people I meet in
   the  United  Kingdom  during the Programme. I understand that the John
   Smith  Memorial Trust reserves the right to withdraw a Fellowship from
   any  individual  whose  behaviour  it deems to fall seriously short of
   these principles during their time on the Fellowship Programme.

   ................................

   Signed:

   Date:

   


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15.05.2015г. распоряжением Минюста РФ СРОО "Сутяжник" включена в реестр иностранных агентов.