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Application for Audiovisual Trainin (r)



Subject: Application for Audiovisual Training course in Brussels 

     AUDIOVISUAL TRAINING COURSE IN BRUSSELS/BELGIUM
     
     OSI/BURMA PROJECT  -  AUTUMN 1996
     
     ----------------------------------------------------------------------
     
     APPLICATION FORM/Deadline: July 15, 1996
     
     Please fill out Part 1 & 2 of the application in English and return it 
     to Burma Project by July 15, 1996 (BURMA PROJECT/OSI, 888 Seventh 
     Avenue, New York, NY 10106, Fax: (212) 489-8455)  The courses must be 
     kept small, so only 3 of the most promising applicants will be chosen. 
     Travel and related costs for successful applicants will be covered.
     
     Use separate sheet if you need more space
     
     Part 1
     
     Name:_____________________________ Alias:__________________________
     
     Address (number & street):____________________________________________
     
     City:________________ Post code:______________ Country:_______________
     
     Telephone:_______________ Fax:_____________ E-mail:__________________
     
     Age:_______________ Sex:______________ Ethnic Group:_________________
     
     Immigration status:__________________________________________________
     
     When did you leave Burma?___________________________________________
     
     Highest education received in Burma:_________________________________
     
     Subject studied:_____________________________________________________
     
     Education/courses elsewhere (in detail):______________________________
     
     ______________________________________________________________________
     
     
     English language ability: (check one) good____ average_____  poor_____
     
     List name of non-Burman language you speak:___________________________
     
     List 3 of your favorite films:________________________________________
     
     ______________________________________________________________________
     
     
     
     Part 2
     
     Explain why you wish to have audiovisual training:
     
     ______________________________________________________________________
     
     ______________________________________________________________________
     
     ______________________________________________________________________
     
     
     Describe the first project you would undertake with your audiovisual 
     training, if you could do anything you wanted:
     
     _____________________________________________________________________
     
     ______________________________________________________________________
     
     ______________________________________________________________________
     
     ______________________________________________________________________
     
     
     Explain why it's important for people in a country like Burma to get 
     the opportunity to be trained at audiovisual techniques.
     
     ______________________________________________________________________
     
     ______________________________________________________________________
     
     ______________________________________________________________________
     
     ______________________________________________________________________
     
     
     Signature:_______________ Print name:______________ Date:_____________
     
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