Human Rights Summer School (HRSS)

Participant’s Application Form

* *Application Fee: 500/- BDT only for domestic applicants to be
paid by bKash (non-refundable) at 01949411872 or 01722438116
1. PERSONAL DATA
Applicant Name (In BLOCK Letters):

Present Institution: Year:

Date of Birth: Day: Month: Year: Gender:

Nationality: Religion/ Faith:

Complete Mailing Address:

Permanent Address:

Mobile No.: E-mail:

2. ACADEMIC BACKGROUND (Attach Attested copies of Certificates)

Grade
Name of Group / Passing
Board / Institution
Degree Subject GPA / CGPA Year/Status

S.S.C./ O Level
or Equivalent
H.S.C./A Level
or Equivalent
LL.B. (Hons.)

3. LANGUAGE PROFICIENCY (Mention: Fluent, Fair or Moderate)

English Speaking: Writing: Reading:

Other(s) Speaking: Writing: Reading:

4. PREVIOUS TRAINING EXPERIENCE (If any)

Medium of Special
Program Title Organizing Institution Time/Year
Instruction Achievement

5. EXTRA-CURRICULAR FEATS (If any) [Please Attach Proofs]

Human Rights Campaign:

Social Service:

Volunteering:

Cultural Activities:
 6. CONTRIBUTION TOWARDS DISADVANTAGED PEOPLE (If any)
Have you ever worked for any disadvantaged people/ group? If so, specify.

7. ENAGAGEMENT/ ATTACHMENT WITH RENOWNED ORGANIZATION (If any)

Organization Position Responsibilities Time/Year

8. HEALTH INFORMATION (This is intended only for your health and safety)
Please mention any special condition of your
physical or mental health (if applicable):

Please put tick if you have any of the listed

Asthma Migraine Epilepsy
diseases:

Please list any medication(s) you take:

Please mention any food/ drug allergies you have:

9. STATEMENT OF INTEREST (Please use extra page)

Why do you want to participate in the HRSS? Explain the relevance of HRSS spirit and experience
in your future career plan [Maximum 300 words].

10. PROBLEM SOLVING (Please use extra page)

i. In three sentences write the need for promoting equality and non-discrimination.

ii. In five brief sentences, mention the core elements that should be taken into account while
framing a Constitution.

iii.Write three sentences about the impact of technology and social media on human rights.

iv. “The Fundamental Principles of State Policy (ESC Rights) are not judicially enforceable”—
Comment.

v. Some scholars argue that we should develop a South Asian native jurisprudence. Share your
idea about such thought.

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 11. REFEREE INFORMATION

Name Name
Designation Designation
and and
Institution Institution

Address Address

Mob. No. Mob. No.

E-mail E-mail

12. DECLARATION
I certify that the information submitted on my application form was complete and correct at
the time of submission. Further, I understand that misrepresentation of any information or
failure to provide necessary documents may result in my ineligibility for admission.

If selected I also hereby agree to pay the registration fee 10000.00 BD Taka only (domestic
applicants) or USD $ 150.00 only (international applicants)

**Please take note that, if selected the domestic applicants have to pay the registration fee
by 30th September, 2018. The international applicants, if selected, shall pay the registration
fee at the HRSS Registration Desk on 13th October, 2018.

Signature: Date:

13. bKash transaction ID (only for domestic applicants):**

** Please send 500/-BDT to 01949411872 or 01722438116

Instruction for submission:

Please send the completed application form along with all necessary documents required
for the application with a color passport size photograph (not older than six months)
preferably in a single PDF file to the following email, mentioning your name and University
in the subject line (e.g. Saira Rahman, University of Dhaka) and your bKash transaction ID
in the email:

hrssapplication@gmail.com
For all queries please
contact:
hassan.elcop@gmail.c
om or
hrssapplication@gmail.com

For further information on ELCOP or HRSS please visit our website:

http://www.elcop.org/