Short Course Application Form

Enrollment Form

UPEACE does not grant any scholarship for these courses. Travel and living expenses are to be covered by the applicant.
For requirements and further information, go to http://www.upeace.org/academic/training/institute/about.cfm.

Offered Courses:

Three Credit Courses

The applicant will only be allowed to enroll in one three-credits course. Please, indicate if you will take the course for graduate credit or training purposes or other.

Graduate	Training
12-30 January
		ENTREPRENEURSHIP IN THE SOCIAL SECTOR: MAKING IT HAPPEN
		PEACE OPERATIONS
		PEACE, CONFLICT AND DEVELOPMENT
		HUNGER, FAMINE AND FOOD SECURITY
		ENVIRONMENTAL SECURITY ASSESSMENT: PRINCIPLES AND PRACTICES
		DEMOCRACIA Y DESARROLLO EN LATINOAMERICA (This course will be taught in Spanish)
		FACILITATION AND DRAMA METHODS FOR CONFLICT TRANSFORMATION

Two Credits Courses

The applicant is allowed to enroll in up to 3 credits. Please, indicate if you will take the course for graduate credit or training purposes or other.

Graduate	Training
12-23 January
		SPORTS AND PEACE
19-30 January
		MEDIA, INSURGENCY AND TERRORISM

One Credit Courses

The applicant is allowed to enroll in up to 3 credits. Please, indicate if you will take the course for graduate credit or training purposes or other.

Graduate	Training
12-16 January
		TERRORISM IN THE ISLAMIC CONTEXT
		HUMAN RIGHTS AND CHILDREN
19-23 January
		FUNDRAISING FOR SUSTAINABLE DEVELOPMENT PROJECTS
		HUMAN RIGHTS, WOMEN, AND ISLAM: THE CASE OF IRAN & AFGHANISTAN
26-30 January
		HUMAN RIGHTS ACTIVISM: THEORY AND PRACTICE
		FILM AND CONFLICT

PERSONAL INFORMATION:

First Name:

Last Name:

Birth Date:

Month	Year (use the 4 digits)

Gender:

Male Female

Country of Citizenship:

Passport Number:

		Month	Year (use the 4 digits)
	Expiration Date:

CONTACT INFORMATION:

Home Telephone:

Office Telephone:

E-mail:

Mailing Address:

Country:

HEALTH INSURANCE INFORMATION:

Name a beneficiary for health insurance policy:
State kinship of beneficiary:

ENROLLMENT INFORMATION:

How do you plan to finance this course?

Own funds
Other
If you chose "Other" please explain:

Please explain your interest in participating in this short course:

Have you previously attended a University for Peace short course or degree programme?

Yes | No
If yes, please provide the name of this course or degree programme, dates of attendance and your student ID number (if available):

REGIONAL EXPERIENCE:

1. Please indicate the regions where you have worked or studied:

Region Years worked
or studied:

Asia and the Pacific

Central and Eastern Europe

Eastern and Southern Africa

Meso America and the Caribbean

North America

Northern Africa and the Middle East

South America

West and Central Africa

Western Europe

2. Please specify the areas of your work experience

Peace Studies

Education for Peace

Human Security

Natural Resources and Peace

International Law and Human Rights

Gender Studies

Peace and Socioeconomic Development

Other

3. Please include any other comments about your work experience that are relevant for your participation in this course:

PREVIOUS UNDERGRADUATE AND GRADUATE STUDY:

1. Please list in chronological order, the higher education institutions where you have studied, starting with, the most recent:

Institution City / Country Date Begun
(MM/YY) Date Ended
(MM/YY) Degree
and Major Date Awarded
(MM/YY)

2. Please provide any additional information related to your academic history which may be helpful to us in reviewing your application:

CURRENT AND PAST WORK EXPERIENCE:

1. Please list in chronological order your work experience, starting with your current or most recent position:

Institution / Company City / Country Date Begun
(MM/YY) Date Ended
(MM/YY) Position

2. Please provide any additional information related to your work history which may be helpful to us in reviewing your application:

ADDITIONAL INFORMATION:

1. Please indicate in which languages you are proficient: English
Spanish
Other

2. Please check if you have any of the following disabilities: Blindness
Deafness
Limited Mobility Specify:
Other Specify:

3. Do you have medical or religious dietary restrictions?:

4. Where did you hear about this short course or degree programme: I received an e-mail announcement.
I read a printed brochure or flyer.
I visited your website.
A friend/colleague recommended this course.
A professor recommended this course.
A former University for Peace student recommended this course.
I read about your courses on another website [ Which website? ]
Other [ Please explain: ]

If you chose "Another Website" or "Other" please explain