Application Form
A. PERSONAL DATA
1.Full Name:
2.Family Name (Last Name, Surname) Only:
3.Employer/Organization:
4.Position/Title:
5.Business Address: (not to exceed 40 characters per line)
6.Business Telephone:
7.Fax (if any):
8.Email address (if any):
9.Home Address: (not to exceed 40 characters per line)
10.Home Telephone:
11.At which address would you like to receive your mail?
__ Business
__ Home
12.Which phone number do you prefer we call?
__ Business
__ Home
13.Date of birth (day/month/year):
14.Nationality:
15.Name as it appears on passport or other travel document:
16.Passport number:
17.Country issuing passport:
18.Knowledge of English: Please rate your knowledge in these categories:
Listening/Comprehension Poor Fair Fluent
Reading Poor Fair Fluent
Speaking Poor Fair Fluent
Writing Poor Fair Fluent
19. Do you use English?
[ ] at worK
[ ] at home
[ ] other
20. Have you attended any international meetings or workshops (conducted
in English). Please give an example.
B. INSTRUCTIONAL TRACKS
Instructional track applied (Select only one track; the tracks will run
in paralell):
Track 1 Web-based Information Services
Track 2 Online Policy and Advocacy
Track 3 Information Management Using Databases
C. TRACK-SPECIFIC QUESTIONS
For All Applicants:
1. Do you have experience in using the following Internet services?
(Please qualify your experience using 0 to 5, 0 means no experience and
5 a lot of expertise)
[ ] Email
[ ] Mailing List
[ ] News Groups
[ ] World Wide Web
[ ] Search engines
[ ] Portals/directory Services
[ ] Other (specify):
2. Describe how you use the Internet in your work, for education,
entertainment, communication and for other purposes.
For Applicants to Track 1:
1. Do you have experience in running Web-based information services?
(Please qualify your experience using 0 to 5, 0 means no experience and 5
a lot of expertise)
[ ] Write HTML
[ ] Provide information on a Web server maintained by others
[ ] Set up, run and maintain Web servers
[ ] Other (specify) :
2. What role do you play in preparing information for a website, for
publications or for other media?
Administration Implementation Support
a. writing/editorial
b. graphic design/layout
c. media work such radio/video
d. public relations and
e. information dissemination
For Applicants to Track 2:
1. Do you have experience participating and/or maintaining mailing lists?
(Please qualify your experience using 0 to 5, 0 means no experience and 5
a lot of expertise)
[ ] subscribing to a mailing list
[ ] participating in an online discussion group
[ ] facilitating an online discussion group
[ ] running/maintaining a mailing list
2. Describe your organization's policy and advocacy work and your role in
these acitivites?
For Applicants to Track 3:
1. What services are you involved in at your workplace and what role do you
play in these services?
Administration Implementation Support
a. Information disemination
b. Publication
c. Repackaging of information
d. Information and reference service
2.Please list the database software(s) you use in your work.
D. DESCRIPTION OF ROLE IN ORGANIZATION/NETWORK's INFORMATION ACTIVITIES
(Your answers to the questions below will be used to determine whether to
admit you to the workshop. Please be sure that your information is sufficiently
clear, well organized and adequate for this purpose.)
1. A summary of your relevant educational and professional background.
2. A description of your current employer/organization, your position, your
duties and responsibilities.
3. A brief description of your computing and networking environment
(operating systems, networking software, modems, etc.), including the
connectivity of your organization to the Internet.
3a. Scope of your institution (check all categories that apply):
Local Community
National
Regional
Sub-regional
Global
Other; Specify
4. Does your organization use information and communication technology? How?
5. In what way is the Internet useful for you and your organization? In 2-3 paragraphs,
please describe your organization's plans vis-a-vis the use of information and communication
technology (Internet services, database) in its information, networking and advocacy activities.
6. What role do you play in your organization information and communication strategy?
7. How you expect to use the knowledge you gain at the workshop. Please answer in 3-4
paragraphs.
8. Have you previously attended Internet-related training?
Yes No
If yes,
9a. Year and type of training:
9b. Did you find it useful? In what way?
E. FINANCIAL INFORMATION
You MUST fill out the following financial information.
Participants are required to pay US$300 registration fee to cover a portion of the actual training cost.
AWORC has been able to raise funds to support international travel cost for a limited number of
participants. We encourage interested applicants to raise part or all of the international travel cost.
1. Will you be able to provide your own airfare?
Yes No
2. Will you be applying for scholarship/subsidy?
Yes No
3.List the agencies where you are requesting financial aid, how much, and when you exepect them
to reply.
Agency Requested Amount Date
U.S.$
F. HOW TO APPLY
APPLICATION CAN BE DONE VIA WEB, EMAIL, FAX OR POST.
1. If applying by ELECTRONIC MAIL, copy and paste the questionnaire on
your email message.
***Please use plain text, no attachments.***
The "Subject" line of the message should contain your surname or family
name in the following format:
Subject: WENT2001 Application: last-name, first-name
Applications submitted electronically should be sent to: went-apply@jca.apc.org
2. If applying by FAX or POST, print and fill up the application form and
send to:
Asian Pacific Women's Information and Network Center
Sookmyung Women's University
53-12 Chungpa-Dong 2-Ka,
Youngsan-Ku, Seoul, 140-742, Korea
Attn: WENT2001 APPLY
Tel. No: +82-2-710-9886, 9687
Fax No: +82-2-710-9689
3. WEB applications will be available from April 20, 2001.
Visit http://www.jca.apc/org/aworc or email went-info@jca.apc.org
for more information.
