unesco peace University North American Office: mail all education video are free        no fee       director   Dr Albert TAN            

celebration of George tan education fund -chiyu bank of china    , hong kong

  5490 ross street , Vancouver, B.C. v5w3k9, Canada Telephone 01 (604) 3249302 604 8138423 joyscience@yahoo.com ASSESSMENT & EVALUATION PORTFOLIO To be completed by all applicants This information outlined is required for a proper evaluation and to facilitate the award. Failure to provide all of the requested information or a lack of sufficient detail may delay processing or result in denial of the award. While programs are innovative and liberal, assessment standard must be maintained to ensure the credibility and integrity of the awards. A. Contact Information 1) Name of Applicant _________________________________________________ 2) Mailing address of applicant _________________________________________ ________________________________________________________________ 3) Telephone number of applicant ______________________________________ 4) Fax number, if applicable ___________________________________________ 5) E-mail, if applicable ________________________________________________ B. Personal References Name, address, phone or e-mail of (2) people who are well acquainted with applicant and who will attest to his or her character and skills. 1) ________________________________________________________________ 2) ________________________________________________________________ C. Education List schools attended and date, beginning with high school, whether graduated. List course taken, seminars and symposia attended. Attach copies of certificates, diplomas, letter of commendation, awards, received, etc. Include transcripts, particularly if credits are to be transferred in. Note: complete, detailed information will support positive evaluations at the highest levels of recognition. Use extra sheets if necessary. Mark each extra sheet to correspond to the topic – Exhibit “C”, for example ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ D. Life Experience 1) Provide details of work history, avocations or hobbies, charitable or social work, any other interest and activities related to field of interest. Use extra sheets as noted for C. 2) Documents all independent study in the field of interest via informal listings, bibliographies, descriptive narrative, etc. 3) List papers or book written, research projects, trips or expeditions, other achievements of relevance to this application. E. Professional Practice Provide details of all therapies or modalities practiced with or without licensure. Provide copies of all relevant licenses, diplomas, certifications, and memberships. Have you ever been disciplined by a professional association or had a license revoked or suspended? If yes, please explain: ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Note: Attach separate sheets as needed. Mark sheets “Exhibit E,” etc. F. Achievements List any and all awards, certificates, letters of commendation, medals, etc. Provide copies where feasible. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ G. Curriculum Vitae or Resume Attach complete resume, marked “Exhibit G.” Note: this application form is itself a resume format. If your resume provides some of the requested information, you need only fill in what is missing. If you have no resume, fill out this form as completely as possible and feel free to send supplemental material. H. Award Sought ڤ Doctor of ____________________________ ڤ Master of Science ڤ Master of Arts ڤ Master of ____________________________ ڤ Bachelor of Science ڤ Bachelor of Arts ڤ Bachelor of ___________________________ ڤ Diploma in ___________________________ ڤ Certificate in __________________________ Major: ______________________________ I. Assessment Fee (Tuition) see fee schedule I am enclosing a Bank Certificate Check or Money Order made to: _________________ Fees are refundable if application is not accepted. J. Enter the name of the agent or referrer (if any): ______________________________ Enter the Agent/Referrer’s Scholarship Code (if any): ____________________________ K. Notarized Statement ___________________________________, _________________________________ County or Township State or Province Before me appeared _______________________________________ who is well known to me or who provided identification and stated that all the information herein (A-F) and on Exhibit “G” attached is true to the best of his/her knowledge and belief. By ___________________________________________________________________ Notary or other officer empowered to take oaths or affirmations (Signature) My commission expires __________________________________________________