Mediation Across Cultures 2008 Application, page 1

APPLICATION FORM FOR

CONFLICT COUNSELING AND MEDIATION ACROSS
CULTURES
120 HOUR CERTIFICATE COURSE 2008

1. Background information

A. The Rationale for Peace Bridges Offering This Program in

Cambodia

Peace Bridges (PB) is committed to equipping both expatriates and

Cambodians, with resources to better ensure conflicts can be dealt with in
an equitable and constructive way. While the primary focus is upon
building Cambodian capacity, PB is seeking to ensure up to 25% of those
we equip and mobilize are Expatriate. Three key reasons for this are:
 There are few services set up in Cambodia for expatriates to deal
effectively with conflicts.
 Expatriate to expatriate conflicts sometimes undermine the
effectiveness of church and community development initiatives.
 Expatriate to Cambodian conflicts are often best resolved by jointly
involving Cambodian and expatriates equipped with common skills
and vision for peacemaking.

PB originally began with a vision of jointly training expatriate and

Cambodian mediators. Following an external evaluation of our first one
year certificate in conflict counseling and mediation it was determined that
Cambodian and expatriate learning needs are better served through
separate trainings. PB is now training a fourth cohort of Khmer
peacebuilders and completed the first English-speaking Mediation Across
Cultures course in May 2008. Now that PB has built the capacity of a
Cambodian training team we are in a better position to also focus on
offering a shorter course to Expatriates and some Cambodians with a very
high level of written and spoken English.

B. Course Overview: 8am- 3pm daily, Phnom Penh

Unit One: August 25-29 2008
~Introduction to effective peace maker strategies for conflicted
groups
~The mediation process: Overview; Introduction/welcoming skills
Unit Two: September 22-26 2008
~The mediation process: Story telling; Summarizing; Issues
identification
~Exploring issues that need healing and issues that need problem
solving
Unit Three: October 20-24 2008
~The mediation process: Options generation & evaluation; Reaching
an agreement
~Ethical dilemmas and contextual issues
Unit Four: November 17-21 2008
 Mediation Across Cultures 2008 Application, page 2

~Conflict counseling, conciliation and facilitation skills

~Group processes and considerations for communities and
organizations
~Final review; Skills Self-Assessment

C. The model of mediation

The model of mediation taught by Peace Bridges is adapted to the

Cambodian Context from “Interpersonal Mediation: One Model” as outlined
in Chapter 4 of the Mennonite Conciliation Services Mediation and
Facilitation Training Manual, fourth edition (Editor: Carolyn Schrock -
Shenk). The three main sources for the training are: Mennonite
Conciliation Services Mediation and Facilitation Training Manual (4th ed)l;
Materials from the London Mennonite Centre and Peace Bridges’ own
materials.
The teaching methodology includes a significant use of role plays to allow
for skills formation for each new step in the process. Training is participant-
centered, and our learning builds on the experiences and skills of
everyone in the room.

D. Opportunity to join a pool of mediators, available to assist with

Cambodian and expatriate relationship needs.

Successful graduates will be given opportunity to join an association Peace

Bridges is developing for conflict counseling and mediation. The
association will develop ethical, training and practical standards and also
various benefits for members, both Cambodians and expatriates. It is
anticipated that the association will link into an international body in the
longer term.

The PB association will offer a central coordinating point for intake and
referral of mediation or facilitation cases, based upon need and
availability. This would include provision of supervision and occasional
follow up training.

E. Selection Criteria
Peace Bridges will receive all applications yet will make a final selection for
the course based on the following selection criteria:

 The applicant has a long term commitment to working in Cambodia

 The applicant is respected by peers, expatriate and Cambodian, as a
conciliator.
 The applicant’s involvement will ensure a variety of ages and
ethnicities, representing the diversity of the international community
in Cambodia.
 The applicants involvement will ensure equal representation of
women and men
 Conciliation and mediation skills development will enhance the
applicant's work role.
 The applicant is fluent in written and spoken English
 Mediation Across Cultures 2008 Application, page 3

 The applicant is able to attend all sessions of the 120 hour course
and complete assignments

F. Cost
The full cost is $1500-. An early-bird discount of $100 is available for
applicants by 6 June 2008 (for scholarship recipients, the total cost will
not be less than $500-).

G. Scholarships of up to $1000- are available to a limited group of

trainees who can demonstrate they have insufficient funds available to
pay the full amount. The background and situation of the trainee will be
taken into account and PB reserves the right to finally determine those
who receive the discount. Those seeking a scholarship should complete
section 2G below and attach with this application a 200 word maximum
rationale for receiving it. This must include a specific explanation of efforts
made to find a sponsor for the full costs of the course.

H. Deadline for applications is 11 July 2008. Selection will be finalized

by 18 July 2008. The Peace Bridges Office should confirm receipt of your
emailed application within two weeks of it being sent. If no confirmation is
sent you may wish follow up by calling 023 880 100. A non refundable
deposit of $100-00 must be paid by 25 July 2008.

I. Confidentiality. All information contained in this application will be

kept confidential and only used for the purposes of selecting candidates
for the Mediation Across Cultures 2008 course.
 Mediation Across Cultures 2008 Application, page 4

2. Application form
Please email to admin@peacebridges.net Note all information provided will be
treated confidentially, only the training and selection teams will have access to
it. The whole application form should be no longer than four pages, excluding
the supervisors section, using no 12 font.

A. Personal Information

Name:

Gender: Male / Female

Date of birth:

Place of birth:

Nationality:

Present address:

Email:

Telephone:

Family status:

B. Educational background

i) What is the highest level of formal education you have attained?

ii) Please outline any academic qualifications:

C. Role in Cambodia

i) Number of years you have lived in Cambodia:

ii) Organisation you are working for in Cambodia:

iii) Occupation:

iv) Please outline the roles and responsibilities of your current occupation:

vi) Please outline any previous training and /or experience related to
conflict resolution and peace building:
 Mediation Across Cultures 2008 Application, page 5

D. Motivations and Benefits

I commit myself to attend all seven units of the peace bridges training
and have the support of my organization to do so.

i) Why do you want to attend this course?

E. Level of English Fluency.

What is your level of English fluency on a scale of 1 – 5, 1 being basic
English and 5 being equivalent to a native English speaker with a tertiary
level education.

Spoken English

Written English

F. Other languages

Please outline your fluency levels (written and spoken) for any other
languages you speak using the same scale as above

G. Scholarship Information

If you are applying for a scholarship, please check the appropriate boxes:

[ ] I am a volunteer and/or my organization provides basic support for

living costs.

~ My total financial package is no more than:

[ ] US$10,000 [ ] US$15,000 [ ] US$ 20,000 []

US$25,000

[ ] US$ 30,000 [ ] US $35,000 [ ]US$ 40,000 []

more than 40,000

Please indicate how much of the course costs your organization is willing
to pay: $ ______________ .
 Mediation Across Cultures 2008 Application, page 6

Please organize to return this form,

along with the section below which is to be completed by your
supervisor,
to Peace Bridges by 11 July 2008.
 Mediation Across Cultures 2008 Application, page 7

3. Supervisor's Form
This section of the form should be completed by the applicant’s supervisor. Supervisors
please complete the form and email to admin@peacebridges.net before 11 July 2008.

A. Name of supervisor:

B. Name of nominee for training:

C. Position of nominee:

D. Length of time the nominee has worked with this organization:

E. Why do you wish the nominee to attend this course?

F. In your opinion how will this course help the nominee in his/her work?

G. Do you agree to allow the nominee to attend the full 120 hours of
training without interruption?
Yes
No

H. What is the nominee’s level of English fluency on a scale of 1 – 5, 1

being basic English and 5 being equivalent to a native English speaker
with a tertiary level education.

Spoken English

Written English

Phone no to verify this application:

Email address to verify this application:

Employer’s Declaration
Please ask you director, or supervisor to read and sign the following declaration. If you are
unemployed, self employed or an independent consultant please sign this section yourself.

I am aware that if (name of nominee) _________ ______ is accepted into this course they will
be absent from work during the four weeks of training listed below*. I understand the course
is full time and demanding, and my staff person will not be able to take on additional work
duties during this four week period.

*August 25-29; September 22-26; October 20-24; November 17-21 2008.

Employer/Supervisor Signature: Date:

Mediation Across Cultures 2008 Application, page 8