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ASEAN LOGICS 2007 PARTICIPANT APPLICATION FORM 1. Personal Information (As printedin passport) Name Place/Date of Birth Citizenship Passport Number Permanent Address ‘Mailing Address (1 dierent from above) : E-mail Address Phone Number ‘Mobile Phone Number 2. Academic Information Current GPA. TOEFL/IELTS Score* Name of University Academic Major Address of University University’s Contact Number 3. Institution Information (Community-based institution in which you are actively involved) Name of Institution Institution's Area of Interest ‘Address of Institution 7 Institution's Contact Number *) Optional, please circle one of your choice ASEAN Logics 2007 International Relations Department: Gedung & Lantai 2, Faculty of Socal and Poltical Sciences (FISIP), Unversity of Indonesia Depok, 15424, Indonesia. Fax number: +62-21-787-3744 », | PSERIOS «, ( ry ASEAN LOGICS 2007 ‘yr PARTICIPANT APPLICATION FORM Application documents to be submitted: ‘A one page essay describing your past experience, future goals, and why you deserve to represent your country for one particular topic in ASEAN Logics 2007; @ = Aworking paper on your chosen topic (consult terms of reference for participants’ working Paper); @ — A complete resume; A copy of TOEFL/IELTS score or other English proficiency test (prediction/ institutional/ © _ international is acceptable) ‘Two recommendation letters respectively showing a good academic standing and involvement in community activities; © An official transcript issued by applicant's university; © Preferably other supporting documents indicating your involvement in community activities. ASEAN Logics 2007 International Relations Department: Gedung & Lantai 2, Faculty of Socal and Poltical Sciences (FISIP), University of Indonesia Depok, 15424, Indonesia. Fax number: +62-21-787-3744

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