Application Form Blc

APPLICATION FORM Burma Lawyers’ Council Advanced Internship Programme Pyi-daung-zu Law Academy (jynfaxmifpk Oya'tu,f'rD) photograph

Personal Particulars Name-Letpu

Other -Letpu

Birth Date (1982/07/23)

Place of Birth-Tamu (Burma)

Sex

___Male Citizenship-

Previous Citizenship (if any) -No

Nationality-Burmese (Kuki)

Marital Status

___Unmarried ___Married Mother tongue-Kuki

___Female

___Divorced

___Widowed

Other Language(s)-Burmese,English

Military Service ___

No

___ Yes (If applicant experienced serving in the army or intelligent institution or any other security forces of the SPDC, it is to be mentioned here in detail.)

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Education Institution

Year of Graduation

Degree (if any)

(High School, University, etc.)

Which of the following course(s) have you completed? ___ Burma Lawyers’ Council’s three months intensive training course ___ One year Foreign Affairs Training Course ___ Other courses (specify) Human Rights Training (TOT),Computer Course(Ms-word,Ms-Excel, Ms-Powerpoint,Web designing (The copies of the highest educational certificates, that the applicant achieved, shall be attached with this application.)

Job History Name of employer or organization

Position / Responsibility

1

Employed period

Salary (in Thai Baht)

Any Incident in Life Have you ever committed any criminal offence? ___ No

___ Yes (If applicant committed any criminal offence and he/she is provided penalty by any competent court, it is to be mentioned here in detail.)

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Grounds for Application Applicant is to write one paragraph

__________________________________________________________________________ ________________________________________________________________________________

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Contact Address c/o-WZ-87(A) 1st Floor,Budella Market,

Street & no.

Postcode & district

Country India

Tel. +919953957610

Vikaspuri-110018 City-New Delhi

Email [email protected]

Parents – personal particulars Your father’s name - U Manglal

Nationality-Burmese

Current occupation Farmerm

Previous occupation Farmer

Your mother's name-DawTingnei

Nationality -Burmese

Current occupation-House wife

Previous occupation-House wife

2

My Personal Commitment If I am selected, I will contribute to human rights and democratic cause of Burma for at least five years in association with a democratic organization after completion of internship period and graduation from Pyi-daung-zu Law Academy (jynfaxmifpk Oya'tu,f'rD) founded by the Burma Lawyers' Council, by mainly (1) living inside Burma or

(--------)

(2) making a base along border areas of Burma

(Moreh,Manipur)

(Candidate is to choose only one alternative.) I also agree to comply with the rules and regulations issued by the Burma Lawyers' Council, for interns, so that advanced internship program can be implemented successfully. I agree to accept the termination of internship if I violate the abovementioned commitment or the rules and regulations for interns. ----------------------------Signature of Applicants

Date -----------------------

Commitment of leader of applicant's mother organization or parents I, as the Chairperson or General Secretary of ----------------------------------------------organization, hereby certify that (applicant) is a member of our organization. If he or she is selected as interns, I guarantee that he/she will continue contributing to human rights and democratic cause of Burma after completion of internship period and graduation from Pyi-daung-zu Law Academy (jynfaxmifpk Oya'tu,f'rD) founded by the Burma Lawyers' Council. I will also supervise his or her learning process during internship period as to whether he or she complies with rules and regulations for interns.

---------------------------------------------------Signature of Chairperson/ General Secretary

Date -------------------