PROGRAM APPLICATION FORM Seoul Human Resource Development Center Metropolis International Institute Headquarter Attach Your Scanned Photo Nambusunhwan-ro 340-gil 58, Seocho-gu, Seoul, 137-071, Korea Phone: 82 2 3488 2059 Fax: 82 2 3488 2346 Web : www.seoulmiti.org or www.metropolis.org/MITI E-mail: shrdcinfo@gmail.com Note: Please type in the form in English alphabets or tick(√ ), do not in hand-write for legibility “N/A” should be used where applicable. Do not leave any space blank. Ⅰ. PROGRAM TITLE : Type Here Ⅱ. PERSONAL DATA : (First) Date of Birth Day Month Year (Middle) City/Locality (Last Name) Nationality Gender Religion M ( ) / F( ) e-mail Office Phone SNS(facebook, twitter, qq) Mobile Phone Emergency Contact Name : Emergency Contact Number : (country code) Dietary Requirements : (area code) ※I don’t eat ※ VISA: I need an invitation letter to apply for entry visa issuance. Yes ( Ⅲ. EMPLOYMENT AND EDUCATION Present Position/Title: Department or Division: Name of Organization: Address: Type of Organization: - City/Local Government ( ) - Autonomous Institution of City/Local Government ( - Other ( please specify : ) Term of Employment: from ( ) to present ) ) / No( ) Ⅲ. EMPLOYMENT AND EDUCATION (Continued) Describe your present duties : Training experiences in Korea (if any) Yes ( ) No ( ) If “Yes” Please Specify Name and Period of Program : Organized by : Ⅳ. ENGLISH LANGUAGE PROFICIENCY *Please tick(√) the box. Excellent Good Fair Poor Listening Speaking Writing Reading Mother Tongue : Other Languages: V. STATEMENT OF MOTIVATION AND WHAT YOU WANT TO LEARN 1. State your motivation to participate in this training program: 2. Describe your expectation from this program Ⅵ. What module of the program do you expect to be most valuable? Remarks APPLICANT'S RESPONSIBILITIES If accepted as a participant, I agree: 1)To follow the training program to the best of my ability and abide by the rules of the SHRDC during the training program; 2) To refrain from engaging in political activities, or any form of employment for profit or gain; 3) To return to my home country upon completion of my training program and to resume work in my country; 4) To accept that the SHRDC is not liable for any damage or loss of my personal property; and 5) To accept that the SHRDC will not assume any responsibility for illness, injury, or death arising from extracurricular activities, willful misconduct, or undisclosed pre-existing medical conditions, however, SHRDC will prioritize safety/accident insurance for each participant. Applicant's Name: Date : Signature: Letter of Recommendation Dear President of Seoul Human Resource Development Center: Upon understanding goals and objectives of your international training course and hoping to promote our administrative exchanges, I hereby recommend the following person as our city’s participant in your training program. I guarantee that our applicant will abide by all laws and rules of your city during the program period and will resume his/her job upon completing the course. Applicant’s Profile • • • • • Name of Training program : Applicant’s Name : Present Position or Title : Department or Division : Name of Organization : Recommender’s Profile • • • • • Recommender’s Name : Present Position or Title : Department or Division : Name of Organization : Contact Information : Tel , E-mail (※ We may contact you during applicants’ selection process) Date: Signature: