ICRC

INTERNATIONAL HUMANITARIAN LAW

MID-ATLANTIC REGION STUDENT WORKSHOP
March 19-20, 2011 at the University of Virginia School of Law

APPLICATION FORM
Acceptance in the workshop is competitive and open to U.S. full- and part-time law and
graduate students. Decisions will be made based on the applicant’s relevant course, field
experience and the submitted statement of interest.

Applications must be submitted by February 27, 2011.

Applicants will be notified of acceptance by March 4th.

Personal Information
Name:

Current mailing address:

Telephone: ( ) - (mobile)
( ) - (home)

Email address:

Necessary course materials will be distributed electronically. Please indicate here if you are
unable to receive materials via email. ________

Country of citizenship:

Date of birth:

Education
Name and location of the law school (or graduate school and program) where you are
currently enrolled:

School Name Location Anticipated

Graduation Date
List all international law or related courses you have attended or in which you are currently
enrolled:

Course Title Institution Semester and Year Grade

Received

List all relevant field or practical work experience:

List any recognition you have received for excellence in academic or professional work, in
particular in the field of international law and/or international humanitarian law:

Have you ever been disciplined, suspended, or expelled for academic or other reasons by an
institution of higher learning?

If yes, please explain fully.

Statement of Interest
Please explain why you would like to participate in this workshop (max. 100 words).

By submitting this application, you certify that the information you have given in this application is complete
and correct to the best of your knowledge and belief. You agree to provide updated information if your answers
to any of the application questions should change between now and the beginning of the workshop.

Return this application to:

Jml3fw@virginia.edu

Human Rights Program

University of Virginia School of Law
580 Massie Rd.
Charlottesville, VA 22903