Application form

Regional Program Political Dialogue South Mediterranean

MENA Leadership Academy

2022-2023
Deadline : 27/02/2022

I. Personal Information

 First Name:

Full Name  Middle Name:

(as stated in the passport):
 Family Name:

Date of Birth:

Age:

Sex: []M []F

Marital Status:

Current Home Address:

City:

Country:

Current Postal Address:

(if different from current
address)

Present Nationality:

Email:

Mobile Phone Number:

Konrad-Adenauer-Stiftung T +216 70 029 Info.poldimed@kas.de www.kas.de/poldimed

Regional Program South 460
Mediterranean F +216 71 962 381
Application form
Regional Program Political Dialogue South Mediterranean

II. Educational Background (Add rows if necessary) 2/5

Name of University/
Subject and Possible Attended Certificates, Diplomas,
Institution, Place and
Focus From/ To Degrees Obtained
Country

III. List the trainings, summer schools or academies that you participated in over the
last two years. (Add rows if necessary)

Name of Institution, Attended Certificates, Diplomas,

Subject of Training
Place and Country From/ To Degrees Obtained

IV. List your engagements with Civil Society Organizations or political parties (Add
rows if necessary)

Name of Organization/ Nature of Organization/

Institution, Place and Position Title Membership From/ To Main Duties and
Country Responsibilities

Konrad-Adenauer-Stiftung T +216 70 029 Info.poldimed@kas.de www.kas.de/poldimed

Regional Program South 460
Mediterranean F +216 71 962 381
Application form
Regional Program Political Dialogue South Mediterranean

V. Work and Internship Experience (Add rows if necessary) 3/5

Fill out from the most recent job / work

Organization/ Agency,
Position Title Type of work Period of Working
Location

VI. Language Skills

Language Fluent Good Basic

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VII. Questions (Please answer in English)

What do you expect from your participation in the MENA Leadership Academy and what
are your motives for applying to this programme? (max. 200 Words)

Konrad-Adenauer-Stiftung T +216 70 029 Info.poldimed@kas.de www.kas.de/poldimed

Regional Program South 460
Mediterranean F +216 71 962 381
Application form
Regional Program Political Dialogue South Mediterranean

What do you think is the reason why young people in the region partly prefer protest and 4/5
informal forms of participation to traditional politics (e.g. in political parties)? (max. 300
words)

How do you evaluate the role of civil society organizations or political parties at the
municipal level? What is their added value, what are the challenges? (max. 200 words)

What is your definition of an ideal state? Who would be the main actors of such an ideal
state? (max. 300 words)

Konrad-Adenauer-Stiftung T +216 70 029 Info.poldimed@kas.de www.kas.de/poldimed

Regional Program South 460
Mediterranean F +216 71 962 381
Application form
Regional Program Political Dialogue South Mediterranean

5/5
How will the knowledge and experience gained during this training program
benefit your later civic or political engagement? (Max 100 Words)

VIII. References

Contact Information: Email,

Full Name Institutional/Professional/NGO
Phone Number…

1.

2.

Date: Signature:

Konrad-Adenauer-Stiftung T +216 70 029 Info.poldimed@kas.de www.kas.de/poldimed

Regional Program South 460
Mediterranean F +216 71 962 381