THE DUKE OF EDINBURGHS INTERNATIONAL AWARD

AWARD ATTAINMENT FORM FOR INDEPENDENT AWARD CENTRES

This form is to assist the International Secretariat in the authorisation process of Awards
attained through Independent Award Centres.
Please complete this form using details from the Record Book and return it to your regional
office as soon as possible. There is no need to send the Record Book with this form.
Independent Award Centers name and address:
BANGKOK, THAILAND

Participants name:

Adele Birkenes

Level of Award:
Bronze

Silver

(Has the participant obtained their Bronze Award? YES/NO)

Gold

(Has the participant obtained their Silver Award? YES/NO)

Date of Birth _____________30/07/98________________________

Please remember that the Award cannot be presented until it has been authorised by the
regional office. Award certificates and badges can be obtained from Award Scheme Limited,
Unit 18/19 Stewartfield Industrial Estate, Off Newhaven Road, Edinburgh EH6 5RQ, Scotland,
in the usual way.

Attainment Form

May 2013

DETAILS OF AWARD (It is essential that this is completed in full.)

Participants name

Adele Birkenes

Date Award Started

June 6, 2013

Date Award Completed

June 7, 2013

Service

Activity
(please give details of
service given)

Dates started
Dates completed
Adventurous
Journey

Skills

Nature of venture e.g.

foot, cycle, exploration
Area

Forest Trek

Dates

6th-7th June 2013

Activity
(please give details of
personal goals
reached)

Piano: I learned how to play grand scales in several

different keys, and I became more confident in sightreading and playing complicated classical pieces.
Model United Nations (MUN): I attended the Bangkok
MUN conference in October and the SEASAC MUN
conference in January. I helped to lead Junior MUN for
younger students. Throughout the experience, I
developed my skills in debating and knowledge of
current affairs.
Piano: March 2013
MUN: September 2012
Piano: June 2013
MUN: May 2013
Football (U15 and U17 NIST teams): I improved my
fitness and represented NIST at BISAC. I reached my
personal goal, which was to score a goal in a match.

Dates completed
Activity
(please give details of
personal goals
reached)
Dates started
Dates completed
Residential Section
(Gold Level only)
Attainment Form

Khao Ito - Prachinburi

Purpose

Dates started

Physical
Recreation

Habitat for Humanity: I organized the Primary School

sleep out, participated in the Secondary sleep out, and
went on a One-Day build in Rayong. I helped to
fundraise by operating a booth at Starry Nights and
selling Mama noodles during lunch.
Ocean Marine Guardians: I organized Earth Day
decorations and went to Clean Up the Reef Day. I
planned for constructing an artificial coral reef, a project
we will undertake early next year.
Habitat for Humanity: September 2012
Ocean Marine Guardians: February 2013
Habitat for Humanity: June 2013
Ocean Marine Guardians: June 2013
Trekking

U15 Football: September 2012

U17 Football: November 2012
U15 Football: November 2012
U17 Football: February 2013

Activity
(please give details of
May 2013

purposeful activity
undertaken)
Dates

Signed by Award Leader: ___________________________________ Date: ________________________

Attainment Form

May 2013