CHILEAN AGENCY FOR INTERNATIONAL COOPERATION AND DEVELOPMENT HORIZONTAL COOPERATION
APPROVED LIST OF CHILEAN FISHERIES AND AQUACULTURE PRODUCTS FORCHILEAN AGENCY FOR INTERNATIONAL COOPERATION AND DEVELOPMENT HORIZONTAL COOPERATION
PROPOSED AGENDA THE 2ND MEETING OF THE THAICHILEANCHILEANTHAI JOINT
ESTUDIOS PARA LOS QUE NECESITA LA BECA :
Chilean
Agency for International Cooperation and Development
HORIZONTAL COOPERATION SCHOLARSHIP PROGRAM
Public Management Diploma Program
(Use capital letters in print)
PHOTO
SCHOLARSHIP APPLICATION FORM
NATIONALITY:_________________________________
PERSONAL INFORMATION
Name: (exactly as appears in Passport)
_______________________________________________________________________________
Full Name
Date of Birth:_____/_____/_____/Age:______ Sex:______________
Marital Status: _______________
Name and nationality of spouse:___________________________________________
Passport No. : _______________________ Issued at:____________________
Visa to enter USA: YES ___ NO____
Address in country of domicile:___________________________________________________________
______________________________________________________City:___________________
Private telephone: ________________Work phone: _____________Fax:_______________
Current Email address:_________________________________________________
The following information is voluntary, however for the Chilean Agency for International Cooperation and Development it is important for the Management Improvement program in terms of Gender, as part of a public policy that is being developed in Chile. AGCID thanks you in advance for your cooperation.
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Are you the head of the household? |
No. of children |
Age of Children |
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Male |
Female |
Male |
Female |
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APPLICANT’S ACADEMIC TRAINING
University degree:________________________________________________________________
Issued by :___________________________________________________
(University or Center of Studies)
Date:__________________
Other studies performed:___________________________________________________________
________________________________________________________________________________
Languages:_______________________________________________________________________
Publications,
books, articles or
others:________________________________________________
PROFESSIONAL INFORMATION
Job or current position:_____________________________________________________________
Institution where you work:_________________________________________________________
________________________________________________________________________________
Description of job activities:_____________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Other activities or positions performed:
Period Institution Positions performed
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________
OTHER INFORMATION
Other scholarships obtained: _____________________________________________________________
________________________________________________________________________________
Other information of interest: _____________________________________________________________
________________________________________________________________________________
REFERENCES OR REOMMENDATIONS RELATED TO YOUR ACADEMIC OR PROFESSIONAL ACTIVITIES:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
I hereby declare under oath that all the information I have included in this Application Form is true and verifiable. I further declare that I accept the terms and conditions established in the Summons to the AGCID Scholarship Program in which this Form is inserted.
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_________________________ Date |
__________________________ Applicant’s signature |
Tags: cooperation and, international cooperation, cooperation, development, chilean, agency, horizontal, international
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