2024 LDP-HEI Application Form

APPLICATION FORM

[Update as of 26 February 2024: Slots for the 2024 run of the program has already been filled up. Succeeding applications will still be evaluated but will be put on shortlist when deemed qualified. Waitlisted applicants might be put on priority list for the next run in 2025.]
Privacy Statement and Consent to Use Data

SEAMEO SEARCA respects your privacy, and we are committed to treat your personal data with utmost fairness, responsibility, and security. Thus, personal information that you share with us are treated with uttermost care, integrity, and sensitivity. All personal details and photo/video/audio documentation related to your participation in the 2024 LDP-HEIs program are managed by the Center for educational purposes. Such are gathered for use in Center-generated reports, documents, publications, and audio-video productions; for inclusion in databases of Center participants, partners, and stakeholders; and to send evaluation instruments and other post-training documents as needed; and will not be transferred to any organization that does not have adequate data protection policies. SEAMEO SEARCA will keep your personal data not longer than six years after the fulfilment of the purposes set out in this notice and in accordance with the Center’s data privacy guidelines.

By accomplishing and submitting this Application Form, you signify that you give consent to the collection and use of your personal information, as well as photo/video/audio documentation, for purposes stated above.

Personal Information
Full Name*

Prefix (Dr/Ms/Mr)First NameMiddle NameLast NameSuffix
Email Address*
example@example.com
Country*
Mobile Number*
Number you use for Viber/WhatsApp (include country code, e.g. +63)
Age*
Sex*

MaleFemale
Dietary restrictions, if any*
Type N/A if none
SEARCA will be offering limited and competitive grants for a subsidized program fee for nationals of SEAMEO Member Countries (regular employees of government/public HEIs). Regular rate applies for those coming from private universities.
Are you applying for a SEARCA grant?*

YES, I am applying for a SEARCA grant [Applications closed].NO, I will be sponsored by my University for the full program fee.NO, I will be self-funded and will directly pay the program fee.
If your application for a full SEARCA grant is unsuccessful:*

I will be sponsored by my University for the subsidized program fee.I will seek sponsorship from other institutions.I will be a self-funded participant.I will not participate in the LDP-HEIs program.

Current Employment
I am currently employed in a:*

Government/Public UniversityPrivate UniversityOther
Complete name of your University*
No. of years with the University*
Current position/s*
No. of years in current position*
Department*
Unit / Division / Department / Office
Complete office/university address:*
Name of your immediate supervisor*

Prefix (Dr/Ms/Mr)Full Name
Designation of supervisor*
Email address of supervisor*
example@example.com

Education and Leadership Experiences
Highest educational attainment*

PhDMS/MA/MBS/BA
Degree/s obtained*
Specify your degrees obtained, university, and year awarded
Leadership experiences *
List any previous leadership positions held in the university, projects, advisory boards, professional associations, etc.

English Language Proficiency

Please honestly rate your English language proficiency level. *

	Poor	Average	Good	Excellent
Reading
Speaking
Writing
Listening

Supporting Documents
Signed Personal Statements Form*

in a single PDF format
Cancelof
Signed Nomination Form*

in a single PDF format
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Signed Statement of Commitment Form*

in a single PDF format
Cancelof
Curriculum Vitae (maximum of 3 pages)*

in a single PDF format
Cancelof
Passport bio page (at least six months validity by May 2024)*

in PDF or image format (.png, .jpg, .jpeg)
Cancelof
Should be Empty:

APPLICATION FORM