DANAMON YOUNG LEADERS AWARD 2013 APPLICATION FORM

PLEASE READ THE FOLLOWING INFORMATION CAREFULLY BEFORE COMPLETING THE APPLICATION ELIGIBILITY To participate in the program, you must fulfill the following criterias: 6th semester students, final academic year students or fresh graduates (graduated in 2013) Age maximum 24 years old Minimum GPA 3.00 (scale 4.00) Willing to participate fully in DYLA program on 1-7 December 2013 Have experience(s) in student or community organisation(s) Currently not under employment or contract with a company Energetic, dynamic and creative SELECTION PROCESS The DYLA committee will shortlist and choose 30 Young Leaders based on the completed application form and telephone interview. Therefore, take your time to develop an impressive application. Provide responses to ALL questions with clear, comprehensive, and concise answers. Always provide relevant examples and ensure your word count is within the requested limit. Please complete your application form in English and return the completed application by email to: dyoungleaders@gmail.com or dian.yadin@danamon.co.id no later than 1 November 2013, 17:00 WIB. You can also convert the Microsoft Word format to PDF upon submission. 1. PERSONAL DETAILS FIRST NAME LAST NAME SEX PLACE OF BIRTH DATE OF BIRTH PASSPORT/ID CARD HOME ADDRESS CITY HOME PHONE MOBILE PHONE EMAIL FACEBOOK TWITTER EMERGENCY NAME POST CODE <INPUT TYPE=\ CHECKBOX NAME= MALE > MACROBUTTON HTMLDirectMALE <INPUT TYPE=\ CHECKBOX NAME= FEMALE > MACROBUTTON HTMLDirectFEM CITY COUNTRY DATE MONTH YEAR

CONTACT

RELATIONSHIP HOME PHONE / MOBILE PHONE HOME ADDRESS CITY POST CODE ORGANISATION CITY POSITION

ORGANISATIONAL EXPERIENCE

YEAR

SEMINAR/ WORKSHOP YOU HAVE ATTENDED

YEAR

ORGANIZER

CITY

ROLE

ACADEMIC QUALIFICATIONS

YEAR

INSTITUTION

CITY

DEGREE

HOW DO YOU RATE YOUR ENGLISH LANGUAGE SKILLS?

(PLEASE CHECK ON THE FOLLOWING OPTION) SPOKEN: <INPUT TYPE=\ CHECKBOX NAME= BASIC > MACROBUTTON HTMLDirect BASIC <INPUT TYPE=\ CHECKBOX > MACROBUTTON WRITTEN: <INPUT TYPE=\ CHECKBOX > MACROBUTTON HTMLDirectBASIC <INPUT TYPE=\ CHECKBOX > MACROBUTTON HTMLDirectWORKING

WHAT OTHER LANGUAGES DO YOU SPEAK? OTHER SKILLS/ EXPERIENCES RELEVANT TO THIS APPLICATION 2. YOUR ACHIEVEMENTS WHAT IS THE CURRENT MAJOR YOU ARE UNDERTAKING IN YOUR UNIVERSITY? PLEASE ALSO NOTE YOUR CURRENT GPA.

WHAT KIND OF PROJECTS OR ACTIVITIES EITHER IN SCHOOL/UNIVERSITY OR COMMUNITY HAVE YOU PARTICIPATED IN FOR THE PAST 3 YEARS? PLEASE STATE YOUR CONTRIBUTION TO THE PARTICULAR PROJECTS OR ACTIVITIES. (150 WORDS)