Mentor Pop Fellowship Application Form

MENTOR POP FELLOWSHIP APPLICATION FORM

Please carefully complete each section of the form and email to [email protected] with the supporting documents requested at the end of the application form. In the subject line of the email please clearly state ‘MENTOR POP FELLOWSHIP APPLICATION’.

PERSONAL DETAILS

Surname: First Names: Title:

Other surnames you have been known by: Address:

Post code: Country: Phone number(s) (include country and city code): Email address: Nationality (ies):

Do you already have a passport? Yes/No

If Yes, please include: Passport Number: Country: Expiration Date: PRESENT OR MOST RECENT EMPLOYMENT

Employer: Address:

: From: To:

Job Title:

Main Responsibilities: EMPLOYMENT HISTORY

Please give details of all relevant employment starting with the most recent. If you are still in full time education, please give details of any vacation or part time employment.

Employer Employed Employed to Position held, main responsibilities and from reasons for leaving __ / __ / __ __ / __ / __ Full Name and Address

: Full Name and Address

: Please continue on a separate sheet using the same format if necessary

7 UNPAID POSITIONS Please give details of any relevant unpaid work that you have done and describe your role starting with the most recent. Please add rows if required.

Institution From To Position held, main responsibilities and __ / __ / __ __ / __ / __ reasons for leaving Full Name and Address

: Full Name and Address

: ACADEMIC AND PROFESSIONAL QUALIFICATIONS

Starting with the most recent:

Higher Education Please provide a scanned copy of your highest academic degree.

College or University Dates Subject or Course Examination Grade (if relevant) Attended / Level

Further Relevant Professional Qualifications

From To Qualification / Award Obtained at

Membership of Relevant Professional Organisations / Bodies

Date Membership and Level

Relevant Training Courses Attended

From To Training Provider Course Title and Content COMPUTER SKILLS

Please place an ‘X’ in the column that corresponds to your level of ability.

None Moderate Extensive Word processing (e.g. Microsoft Word)

Spread sheets (e.g. Microsoft Excel)

Databases (e.g. Microsoft Access)

Presentations (e.g. Microsoft Power Point)

Internet/ World Wide Web

Social Media (Facebook, Twitter, Instagram, YouTube, etc) Geographic information systems (GIS)

Statistical software (e.g. R, SPSS)

LANGUAGES (insert additional rows as needed)

Language Spoken Written* (Excellent, good, (Excellent, good, basic) basic) *Please provide evidence of written work RELEVANT AWARDS, PUBLICATIONS OR OTHER RELEVANT RECOGNISED ACCOMPLISHMENTS (insert additional rows as needed)

Date Award / Publication Title / Details

If accepted, you will need to relocate to Yaoundé, Cameroon for the duration of the Fellowship. Please place an ‘X’ in the box to confirm that you understand this:

If you are selected to be a Fellow and you are currently employed, what will your status be with your current employer during the 15 months that you would participate in the MENTOR-POP Program (place an ‘X’ in the relevant box)?

No Paid study Unpaid Other (please explain) Employment (I leave leave will leave my job)

If you will leave your job what is your notice period?

If you will continue to be employed during the MENTOR-POP Fellowship Program, you will need formal permission from your employer to participate. Please contact the appropriate people, such as the Head of your Division and the Human Resources Department, so that they are aware of your application. Please list these people’s names and their job titles below to indicate that you have their support to apply. A formal letter of support (on letterhead) from employers will be required if you are selected. We may use these details to contact your employer to confirm these permissions.

Name Job Title Contact details ABOUT YOU

Please explain why you are interested in this Fellowship and your main motivations for applying. (300 words maximum)

Please explain why you feel you are suitable for this Fellowship and how your skills, abilities and experience match the person specification in the eligibility requirements, with specific reference to your preferred Action Group. (500 words maximum) Please outline what your expectations are for this Fellowship, what you hope to gain from participating in this programme, your future career goals and how this Fellowship programme will help you achieve these goals. (300 words maximum) The MENTOR-POP Programme will have Action Groups on the following: (i) pangolin population assessments; (ii) legal systems and wildlife law enforcement, and; (iii) demand reduction. Please list in order of preference in which Action Group you would want to participate. Use 1 as your top priority, 2 as your second and 3 as your least preferred. Population Assessments Legal Systems and Wildlife Demand Reduction Law Enforcement

In no more than 300 words, please outline a project idea that you think relevant to your preferred Action Group. We are looking for a realistic aim, proposed activities and outcome for a 9 month project. REFEREES (we will only contact these with your permission)

Please provide contact information for two professional references. Please ask the two referees to complete the reference form and ask them to submit it directly by email to [email protected] with your name and ‘MENTOR POP FELLOWSHIP APPLICATION’ in the subject header by Friday, 4 September 2015

Name Company/ Position Address & Dates Contact Organisation Contact details employed details

Referee 1. Should be your most recent employer Referee 2.

HOW DID YOU HEAR ABOUT THE MENTOR POP FELLOWSHIP?

Please let us know how you found out about this Fellowship:

______

PLEASE READ THE FOLLOWING DECLARATION CAREFULLY BEFORE SIGNING THIS FORM

I declare that the information given in this application is, to the best of my knowledge, complete and correct. I understand that the Society reserves the right to seek verification of any information provided. I understand that if it is discovered that I have given false information I may be taken off the Fellowship programme.

Signature*...... Date...... …......

Name (Print)...... …………….………………………………......

*Clear electronic or scanned signatures are acceptable.

Application Checklist:

Have you: Check Completed every part of the application form, keeping to word limits where given? Signed the application form? Included a copy of your CV (max length 2 pages)? Included proof of your English skills (if applicable)? Asked 2 referees to email letters of support to [email protected]? Provided a scanned copy of your highest academic degree? Provided an academic transcript from Bachelor’s or other degree program, if applicable.