I. PERSONAL INFORMATION
Peace through Technology Training Program Application Form
Instruction: Please fill-out the form legibly.
Last Name:
First Name:
Middle Name:
Complete Address:
Email: Mobile: Land line:
Ethnicity: Religion: Gender:
Name of School:
Address:
Status: Currently enrolled Year Level:
Graduated Year Graduated:
Organizational affiliation (if any):
Position (if any): Contact Number:
Email: Website:
If you are an active member of one organization, please give a brief background about the organization and your role in it. (Maximum 150 words)
Date Role Venue
1.
2.
3.
4.
5.
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II. SCHOOL / ORGANIZATION
III. Projects started by you/ Trainings/ Seminars Attended?
How many hours per week do you spend online?
Rate from 1 to 10 your familiarity and proficiency with the following computer applications:
Internet surfing Blogging
MS Windows application MS Word
Excel Powerpoint Spreadsheet Windows Movie Maker
Top three websites that you visit the most:
1.
2.
3.
Other computer application skills: Please specify
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IV. Personal Goal: Why are you interested in applying to this program? (Maximum 100 words)
V. Relevant Experience: Describe previous experiences that you think are the most relevant to this program. (Maximum 250 words)
VI. IT Skills
VII. On a separate sheet, write your assessment of Muslim – non-Muslim relations in your own community and in the Philippines? How can you help improve this relationship? (Maximum 250 words)
I certify that all facts and data provided in this application are true and correct to the best of my knowledge.
Signature over printed name Date:_____________________
Workshops to be attended: First Series Second Series
