<p> PEOPLE POVERTY AND A FIVE WEEKS COURSE NATURAL RESOURCE FOR MID-LEVEL MANAGEMENT COURSE MANAGERS IN GOVERNMENT AND 18 AUGUST TO NON-GOVERNMENTAL 18 SEPTEMBER 2003 AGENCIES</p><p>APPLICATION FORM</p><p>The deadline for submission of applications is 4 July 2003. To apply please fax or email your completed application form and detailed curriculum vitae to IUCN. (See course brochure for contact details).</p><p>Section 1 to be completed by the Applicant 1. Name: (Mr. Mrs, Ms) Surname: Sex: </p><p>2. Birth Date: 3. Country:</p><p>3. Mailing Address: </p><p>E-mail: Fax no: Tel no:</p><p>4. Emergency Contact Person and Address: </p><p>5. Education: Highest educational qualification attained: eg BA, MA, MSc, Please specify</p><p>6. Employment Record A. Present Employer:</p><p>B. Present Position and Occupation:</p><p>7. Indicate how proficient you are in English. </p><p>Poor Fair Good</p><p>8. Medical Insurance: IUCN does not provide Medical Insurance to Training Course Participants and accepts no liability for any injuries or sickness that may occur during the course. Employers nominating participants and the participants should be aware of this condition. 9. Please list other natural resource management related courses that you have attended</p><p>10. Please list reports, case studies etc that provide up to date analysis of the natural resources management sector/area that you work in.</p><p>11. In not more that 12 lines, please state why it is important for you to attend the course. How will your attendance at the course assist you in your work?</p><p>12. Declaration: I certify that I have read the above and answered all questions truly and completely to the best of my knowledge.</p><p>Signature of Applicant: ______Date: ______</p><p>Section 2 to be completed by the Applicant’s Supervisor</p><p>I ……………………………………………………………………….. Designation …………………………………..…………………………………</p><p> nominate………………………….…………………………………………………………….. to undergo the Human and Social Science Perspectives in Natural Resources Management Training. I certify that necessary and appropriate support will be given to him/her to enable him/her to use the knowledge, skills and implement the lessons learnt on the training course.</p><p>Official Stamp</p><p>Signature: ______</p>