Registration Form

2019 Science and Technology Fellowship Registration Form

Please fill in the form below.
Area(s) of Interest *

Digital Economy Innovative Start Ups Science, Technology and Innovation (STI) Policy for UN SDGs
Full Name *

Salutation First Name Last Name
Gender *
Nationality *
Country of ASEAN Member

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

E-mail *
Phone Number

- Area Code Phone Number
Mobile Phone *

- Area Code Phone Number
Current Job Title *
Employer *

Office Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Upload CV *
See Appendix 1 of the Call for Application Document for CV Format
Upload Latest Education Certificate *
Essay 4.a Describe a problem related to your chosen science and technology priority area* that you are keen to address. Give a clear explanation about the importance of this issue and the opportunities and challenges that your government is facing in this area. (*if you are applying for more than one thematic area, please address it in different paragraph in the box below). *

0/400
Essay 4.b Why are you interested in participating in this Fellowship? How will this help you to advance your career and realize your professional goals? *

0/400
Essay 4.c Describe how you demonstrated your leadership skills, took on a leadership role on a project or activity, and/or worked to build consensus among differing viewpoints. Please also describe how your communication and interpersonal skills have helped you to solve the problems in those situations *

0/400
Essay 4.d This is an ASEAN-wide Fellowship. What do you see as the potential benefits of working within/through ASEAN? Please also describe what you anticipate as the potential challenges of doing so. *

0/400
Essay 4.e If you are selected as a fellow to be embedded in your national line ministry or in an ASEAN body, please describe the outputs (e.g. conduct xx training activity for the community on xxx; produce xx policy paper on xxx; etc.) you aspire to complete for one-year fellowship programme in relation with the thematic area(s) that you have selected above . *

0/400
How do you know about this Fellowship progamme? *

Facebook Instagram Twitter LinkedIn Colleagues or Friends Website Mailing list Newspaper/magazine TV Radio
The call for application due at 11:59 p.m Jakarta time on February 24, 2018. Only shortlisted candidates will be contacted for further process. Good luck!
With this application submission, through your submitted email you will receive brief announcements regarding ASEAN Foundation's programmes in the future.
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2019 Science and Technology Fellowship Registration Form