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Application Form

Please read all related sections before filling in the form and note deadline for submission.

Candidates are required to apply for a maximum of three courses, one from each session in your order of preference. For each session, tick 'first' to the left of the course of your first preference. If you have a second preference in the same session with your first, tick 'second' to the left of the course.

Note: Some courses fill up quickly. If your first choice is full and you do not indicate a second choice, you may not be considered for any course for that particular session. You must therefore indicate a second preference that would be considered if you were not accepted for your first choice.

Surname:
Othernames:
Organisation:
Title:	Select One Professor Dr. Mr. Mrs. Ms. Other
Function:	Please indicate your function in your Organisation.
Address:	Please provide your postal address information.
Country:	-- Select Country -- United States Canada Mexico ----------------------- Albania Algeria American Samoa Angola Anguilla Antigua & Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Belarus Benin Bermuda Bolivia Bonaire Bosnia & Herzegovina Botswana Brazil British Virgin Islands Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Rep Chad Chile China Colombia Comoros Congo Cook Islands Costa Rica Cote D'Ivoire Croatia Curacao Cyprus Czech Republic Dem Rep of Congo Denmark Djibouti Dominica Dominican Republic Ecuador East Timor Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France French Guiana Gabon Gambia Georgia Germany Ghana Gibraltar Greece Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kosovo Kuwait Kyrghyz Republic Latvia Lebanon Lesotho Liberia Lithuania Luxembourg Macedonia Madagascar Malaysia Malawi Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mexico Moldova Monaco Mongolia Montserrat Morocco Mozambique Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Oman Pakistan Palestinian Authority Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda St. Kitts & Nevis St. Lucia St. Maarten St. Vincent Samoa Saudi Arabia Senegal Sierra Leone Singapore Slovakia Slovenia South Africa South Korea Spain Sri Lanka Suriname Sweden Switzerland Taiwan Tanzania Thailand Togo Tonga Trinidad & Tobago Tunisia Turkey Turkmenistan Turks & Caicos Island Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay US Virgin Islands Uzbekistan Vanuatu Venezuela Viet Nam Yemen Yugoslavia Zambia Zimbabwe
Telephone:
Fax:
Email:
Personal Details
Gender:	Select One Male Female
Date of Birth:
Place of Birth:
Nationality:
Supplemental Information Statement of Experience:  Please describe your relevant work and experience, past and present Statement of Intent:  Please state your objectives for studying at WAPI and ways in which you intend to apply the training you receive Statement of Financial Support:  Please state how you intend paying for your study Courses and Schedule (please tick in order of preference) Session I: 4 – 8 September 2006
First: Second:	Introduction to Peacebuilding Paradigms
First: Second:	Justice-Building and Conflict Resolution
Session II: 11 – 15 September 2006
First: Second:	Active Nonviolence and Peace Education
First: Second:	Conflict, Population Movement and Development
Session III: 18 – 22 September 2006
First: Second:	'Proventive' Peacebuilding: Early Warning & Early Response
First: Second:	Women in Peacebuilding
Deadline for Application June 30th 2006 Mail, Fax or Email applications to: West Africa Peacebuilding Institute P.O. Box CT 4434; Cantonments, Accra-Ghana Tel. 233-21-221318/221388,256439,258299 Fax. 233-21-221735 Email: wanep@wanep.org Website: www.wanep.org/wapi