Application Form

APPLICATION FORM

Qualifications of candidates for the Peace Program

The criteria and qualifications for a Youth Peacebuilding program targeting individuals between the ages of 18 and 29, will be open to all races, religion, sex, and physical disabilities, including refugees.

Age: Applicants should be between the ages of 18 and 29 as on 1st July, 2025. This age range is often chosen to engage young individuals who are more likely to be open to new ideas and experiences.

Commitment to Peace: Applicants should demonstrate a genuine commitment to peacebuilding, conflict resolution, and promoting understanding among diverse communities. This commitment could be expressed through past involvement in peace initiatives, community service, or related activities.

Educational Background: While not always a strict requirement, having a certain level of education may be considered. This could include a high school diploma, undergraduate degree, or relevant vocational training but most importantly an interest in Peace

Communication Skills: Effective communication is crucial in peacebuilding. Applicants should possess good verbal and written communication skills to articulate ideas, mediate conflicts, and engage with diverse groups of people. Must be proficient in English.

Leadership Potential: The program may seek individuals who show leadership potential and the ability to inspire others. Past leadership experiences, whether in formal roles or community-based initiatives, could be considered.

Understanding of Conflict Dynamics: A basic understanding of conflict dynamics, both local and global, may be required. This could involve knowledge of historical conflicts, cultural awareness, and an understanding of the root causes of violence.

Collaboration and Teamwork: Peacebuilding often requires collaboration and teamwork. Applicants should be able to work effectively in groups, respect diverse perspectives, and contribute to collective efforts.

Innovative Thinking: The ability to think creatively and propose innovative solutions to conflicts is valuable. This may involve developing and implementing projects that contribute to peacebuilding in unique and effective ways.

Passion for Social Justice: A strong commitment to social justice and equality is often sought in peacebuilding advocates. This includes a dedication to addressing underlying issues that contribute to conflict, such as inequality, discrimination, and injustice.

Recommendations and References: Applicants may be required to provide letters of recommendation or references that speak of their character, commitment, and suitability for the program.

Commitment to purse the agenda of peace: to be the advocates of peace as Peace Ambassadors and to initiate further programs and activities in peacebuilding amongst youth.

Please upload the completed Club or District Consent form.You can download the template using the link below. Upload option is just before you submit the application.

https://events.aseanrotarypeacebuilders.org/images/Club%20or%20District%20Endorsement1.pdf

Participant Name*

First NameLast Name

Date of Birth*

Date

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Country

Email*

example@example.com

Mobile*

Age*

Gender*

Candidates Educational Background*

Participants Profession

How proficient are you in English (1 is Low and 5 is High)

Reading*

1 Low2 Average3 Good4 High

Writing*

1 Low2 Average3 Good4 High

Understanding*

1 Low2 Average3 Good4 High

Upload Passport/National ID*

Upload Latest Certificates*

Describe in 500 words, your understanding and commitment to peace and what change you would like to see in your community and how you plan to achieve this after your training.*

0/500

Emergency Contact Name*

First NameLast Name

Relationship to Candidate*

Contact Number*

Provide one reference contact name*

Should not be Relative or Rotarian

Profession/Company of the Referrer*

Referrer's Email*

example@example.com

Referrer's Mobile*

Please consent to the following: Select All*

I understand that this is a fully sponsored short term program in peace and I give my undertaking to participate in this program fully and am required to sit for the end of course assessment. I am also committed to report back to my sponsor Rotary Club in my country of origin and work under their supervision in at least 2 projects in peacebuilding in my community for the next 12 to 18 months.

I also understand that I will be responsible for the round flight ticket, cost of any visa if required and travel, health and safety insurance covering the entire duration of the training till departure from site and arrival in home country.

I consent to be part of the Youth Peace Ambassadors virtual group and will be available to actively participate and provide my services in peacebuilding to youth in my community.

Name*

Signature*

Training Event Waiver, Release of Liability, and Medical Consent Section.

Mandatory Acceptance*

Acknowledgment of Risk :- I understand and acknowledge that participation in the Youth Peacebuilders Training hosted by Rotary Club of Ipoh Central and its partner clubs and in partnership with Sunway University, involves physical activities that carry certain inherent risks, including but not limited to sprains, strains, fractures, and other potential injuries. I voluntarily participate, fully accepting such risks.

Release of Liability :- In consideration for my participation, I hereby release and hold harmless Rotary Club of Ipoh Central and its partner clubs and in partnership with Sunway University its employees, volunteers, agents, contractors, sponsors, and affiliates from any and all claims, liabilities, or damages resulting from injury, illness, or loss sustained by me or their property during the Event, except in cases of gross negligence or willful misconduct.

Medical Conditions, Allergies or Medications :*

By registering for and attending this event, I grant the event organizer, Rotary Club of Ipoh Central, Rotary International District 3300 (M) Berhad and their respective contractors, representatives, and licensees, hereafter referred to as the Organisors, permission to record my name, image, voice, statements, and likeness (“Likeness”) in any media, including photographs, video recordings, audio recordings, interviews, and other forms of media (“Recordings”), without payment or other compensation. I understand and agree that the Organisors shall have a perpetual, worldwide, royalty-free right to use, publish, display, distribute, reproduce, modify, adapt, live stream, broadcast, publicly perform, transcribe, and create derivative works using the Recordings for promotional, educational, archival, and marketing purposes. I further acknowledge that the Organisors may license the Recordings, including my Likeness, to its partners, affiliates, and members for the same purposes without requiring further consent from me. I understand that the Recordings may appear in Rotary’s publications, websites, social media channels, press materials, and other platforms, and may be accessed by individuals worldwide. I waive any right to inspect, approve, or seek compensation for the use of the Recordings. Further, I authorize the event organizer to share certain personal data with Rotary International. Any personal data shared with Rotary will be used only for official Rotary business and in accordance with Rotary’s Privacy Policy, available at rotary.org/privacy. My personal data will be used to facilitate my attendance and participation in this event and the creation and use of the Recordings. My personal data may be transferred to Rotary service providers. I release and hold harmless the event organizer, Rotary, and their respective affiliates, contractors, representatives, and assigns from any and all claims, liabilities, or damages arising from the use of the Recordings or your Likeness. This Release shall be binding upon my heirs. I understand that it is my responsibility to remove myself from areas where recording or photography is taking place if I do not agree to be recorded or photographed. I acknowledge that I have read and understand these terms, and I consent to the collection and use of my name, image, voice, statements, and likeness as described. By signing below, I affirm that I have read and understood this document, and that I consent to the terms outlined herein.

Upload Club or District Consent Form *

Please upload the completed Club or District Consent form You can download the template using the link below, incomplete applications will not be processed. https://events.aseanrotarypeacebuilders.org/images/Club%20or%20District%20Endorsement1.pdf

ASEAN Rotary Peacebuilders