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Australia Awards – Africa

2018 Intake Application Form


Award Level: Australia Awards – Short Course
e-Application Form: Cameroon
How to Complete This Form

Each year, over half of the applications received by Australia Awards Africa are automatically
rejected because they are received late, are incomplete or are from applicants that do not meet
the eligibility criteria for their country. Please take time to read these instructions carefully, read
the Eligibility Criteria (EC) and ensure you submit a full and complete application.

Please complete this form in ENGLISH.


Eligibility Criteria (EC
www.australiaawardsafrica.org
You must complete all applicable sections of this form and provide all supporting documents.
Please ensure you complete the checklist of documentation required, which appears at the end of
the Application Form.

Other Information - Gender and Disability Inclusion


Australia Awards encourages people of diverse backgrounds to apply for the scholarships.
People with a disability, or people from disability organisations, are encouraged to apply.
As set out in Development for All 2015 2020: Strategy for strengthening disability-inclusive development
, the Australian Government is committed to offering educational opportunities
to eligible people with disabilities. The UN Convention on the Rights of Persons with Disability (2006) that
the Australian Government has ratified, adopts a social model of disability that recognises those who have
long-term physical, mental or sensory impairments which in interactions with various barriers may hinder
their full and effective participation in society on an equal basis with others.
Disclosing a disability will not disadvantage you in the application or selection process. Disclosure of
disability enables us to support your participation. Reasonable adjustments will, where required, be made
to ensure equitable participation by all who participate on the award.
For further information on disability inclusion at Australia Awards visit:
http://www.australiaawardsafrica.org/about-australian-awards/information-for-people-with-disability/
Women and those working in gender equity related fields are encouraged to apply.
The Australian Government has an equal access policy for its scholarship opportunities as outlined in
(DFAT 2016). To this end, Australia Awards
Africa is keen to ensure that women participate equally in the program and have equal opportunities to
benefit from the Awards. Women are encouraged to apply and will be supported, as applicable, during
the selection process and once awarded.
For further information on disability inclusion at Australia Awards visit:
http://www.australiaawardsafrica.org/about-australian-awards/information-for-people-with-
disability/
Reintegration Action Plan (RAP)
In this section of the application form, you are required to document how the skills you gain from the
Short Course Award will be put to use once you return to your workplace.
Should you be successful for a Short Course Award, you will be asked to review your RAP at the
commencement and conclusion of your program of study. A RAP Report will be required to be submitted
to Australia Awards Africa periodically after your award has been completed. You could also be asked
to participate in post-course visits between participants and the training providers, and other Monitoring
and Evaluation activities.
Your application form is confidential and DFAT will only share the content (if necessary) once applicants
have signed the authorisation on the final page of the application form. If you are offered an Australia
Award you will be required to sign a contract, and will be bound by the conditions of the relevant award.
Under the terms of their contract and visa, Short Course Award recipients are required to return to their
country on completion of their Award, and not seek to re-enter Australia for a term that is at least twice
the length of time they were in Australia, the minimum term being 6 months.
If you have any questions about the Australia Awards Africa, including the application process,
deadlines, and the courses you are eligible to apply for, further details are provided on the websites
mentioned below.
Checklist
Please use the Checklist included in the application form to verify that you have complied with all
application requirements. If the required documents are not submitted, your application will be treated as
non-compliant.

Important Information about Eligibility


To be eligible to apply for an Australian government-sponsored scholarship, you must:
 be a citizen of a participating African country and

 meet the age restrictions for the award which vary by country see the Australia Awards Africa
website: www.australiaawardsafrica.org for more details.

You are not eligible to apply for a Short Course under Australia Awards Africa if you:
 currently hold an Australian Government scholarship

 hold citizenship or permanent resident status in Australia or New Zealand

 are married, or engaged to be married to someone who holds or is entitled to hold citizenship or
permanent residency in Australia or New Zealand

 do not hold a B

 are unemployed, or will not return to your current employer and current role after completion of the
Short Course Award

 have ever been convicted of a serious crime, or are currently facing legal action or police charges in
any country relating to allegations of serious criminal activity

 have committed or been involved in, or are under investigation for involvement in, the commission of
war crimes or crimes against humanity or human rights abuses.

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake ii
If any of the above are the case for you, please do not apply. Applicants will be required to provide a
statutory declaration attesting to their police record and awardees will be subject to screening processes.
Following endorsement by applicants of an authorisation in relation to use of personal information
(Declaration, page 20), names of successful nominated awardees may be published widely in the media.
EC,
and meet any necessary pre-requisites for your particular field of study, please fill out this application form
and submit it to the Australia Awards Africa by the due date of:

15 January 2018
For further information:
DFAT Scholarships: dfat.gov.au/people-to-people/australia-awards/pages/australia-awards.aspx
Australia Awards – Africa: www.australiaawardsafrica.org
Or contact us by email: enquiries@australiaawardsafrica.org

Submitting your e-Application


Before you begin to fill in the form, be sure to establish a reliable email address. Your application will be
submitted by email, and all correspondence with Australia Awards Africa will be via email. Use the same
address for all correspondence with Australia Awards Africa. Record this email address in the Personal
Contact Details section of this form. This email is your registered email address. The registered email
address must be an account to which only you have access do NOT use an account that you share
with others.

To complete the e-Application form:


 Copy the form to your hard disk. Do NOT edit it directly from your email.
 Open this form in a compliant PDF Reader program. Adobe Reader XI is recommended (Note:
Earlier versions of Adobe Reader cannot be used. However, you can use any version of Adobe
Acrobat Standard or Professional.)
 Complete ALL the Eligibility Criteria. If you are ineligible for any of the reasons listed, your application
cannot be considered. If you do not complete ALL Eligibility questions, your Application will be NON-
COMPLIANT.
 Complete ALL the required details in ENGLISH. Applications that are not complete or not in ENGLISH
may be considered NON-COMPLIANT and not considered further.
 You can use the Submission Checklist at the end of this form to make sure you have completed all
required fields.

To submit your application:


 Once you have confirmed that the application is complete, save the filled-in Application form to your
hard disk or to a Flash drive.
 Attach the saved file to a new email message. Send the email to applications@adsafrica.com.au
using your registered email address.
 You may also submit your application using the Submit Application option in the Submission
Checklist at the end of this form. However, this function cannot be used with Web-based email
accounts.

Submitting Supporting Documents


Supporting documents must be emailed in electronic format to applications@adsafrica.com.au.
Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake iii
 Scan each supporting document to convert to an electronic file.

 Attach the scanned file to an email message. Provide a meaningful subject line for the email, and send
to applications@adsafrica.com.au. REMEMBER: Send ALL documents, using the contact email
account you provide in the Personal Contacts of this form.
 AFTER the form is filled in, print these pages:
- Signatures and Commitments
- Statutory Declaration

 Sign and date the Signatures and Commitments page.


 Have your employer sign and date the Signatures and Commitments page.
 Sign the printed copy of the Statutory Declaration before a witness. (A list of those eligible to witness
this document is included in this form.)
 Scan both printed and signed pages.
 Email the scanned signed documents to applications@adsafrica.com.au using your registered email
account.

Frequently Asked Questions


Can I print and scan the e-Application, then send the whole application scanned?
No. Print, scan and sign only the Signatures and Commitments page, and the Statutory Declaration, as
explained above. Save the filled-in e-Application and send the saved file. This allows our systems to
automatically extract the information you have entered in the form.
Can I send all my documents in one email?
You can send as many documents on one email as you like, provided the total size is not over 20Mb. You
may also send as many separate email messages as you like, provided they are all sent using your
registered email account.

Yes, you can compress your documents as ZIP or RAR format archives. This may reduce the size of the
files and make them easier to send. You may include as many files in a single archive as you wish.
My documents are on my sky-drive. Can I just send you the link?
No. We do not accept documents submitted as links to any skydrive, dropbox or other internet location.
The document must be submitted as an attachment to an email message.
If I need to supply extra information, can I just provided it in the body of the email?
No. Messages sent to applications@adsafrica.com.au are automatically processed to extract the
attached documents, and are not read by our staff.
For more information on completing the e-Application, refer to:
http://www2.adsafrica.com.au/FormRequest/technical_tips_and_advice.pdf

The Submission Deadline for this form and all supporting documents is:

15 January 2018

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake iv
Late applications will not be considered.
Please note that we do not take into account the date of posting or submission to the courier company.
You must therefore post or courier your documents in sufficient time to arrive at their destination by the
submission date. Applications received after this date will not be considered.

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake v
Australia Awards – Africa Short Course Award
Application Form 2018 Intake

PART 1: About You


This section collects information about you, and allows you to determine your eligibility for an Australia
Award. Please note that people with disability are encouraged to apply, as are women and people from
rural areas. Disability, sex or other discriminatory factors are not used to disadvantage applicants in the
selection or application process.

From which country are you applying? Cameroon

Personal Information
Title 
■ Mr  Mrs  Ms  Miss  Dr
First Name / Given Name Romaric
(Enter your names as shown in your passport)
Middle Name (if applicable) Emmanuel

Surname / Family Name OUABO

Date of Birth 1989-12-10

Place of Birth Mbo

Current Age 28

Sex  Female 
■ Male

Country of Citizenship Cameroon

National Identity Number 20170142867810885


Passport number Issue date 2014-11-03
(provide if you have a passport) 0208543
Expiry date 2019-11-03

Second Country of Citizenship (if applicable)

Marital Status  Married  De Facto 


■ Engaged
 Divorced  Separated  Widowed
 Never married
No. of Dependents (spouse, children)  None 1 
■ 2 3
4 5 6 More than 6

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake 1
Personal Contact Details
This is for your personal contact details. You will have an opportunity to provide your work address and
contact details later on in this form. The application process will take several months. You must provide a
current email address and phone number where you can be contacted while the selection process
proceeds. If you are not contactable, your application may not be considered.
Residential Address
Enter the address where you live. Do not ent

Street Address Paloma Junction

Efoulan

Town or City Yaounde Postal Code 237

Province Centre

Country Cameroon

Home Phone Number Main: +237 694 268 691 Other: +237 999 9999 9999

Work Phone Number Main: +237 694 268 691 Other: +237 999 9999 9999

Mobile (Cell Phone) Number Main: +237 694 268 691 Other: +237 999 9999 9999

Email
This email address will be used for all
communication regarding your ouamboemmanuel@yahoo.fr
application. Specify an email account
that only you have access to.
Other Email
Enter one alternative email address ouamboemmanuel@gmail.com
(optional).

Postal Address
Postal address may be required if your application is successful. Leave blank if same as residential address.

Address or PO Box PO Box 8538

ARPEDEL

Town / City Yaounde Postal Code 237


Province Centre

Country Cameroon

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake 2
Emergency Contact Details
Provide details of a person who can be contacted in case of an emergency. This may be a relative or friend.

Title 
■ Mr  Mrs  Ms  Miss  Dr

First Name / Given Name Jean Nestor

Surname / Family Name Tagne

Relationship to you Father

Residential Address Banengo

Antenne Télé

Town / City Bafoussam Postal Code 237


Province West

Country Cameroon

Home Phone Number Main: +237 696 185 461 Other: +237 999 9999 9999

Mobile (Cell Phone) Number Main: +237 696 185 461 Other: +237 999 9999 9999

Email jeanestag@yahoo.fr
(Specify one email address only)

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake 3
Eligibility
What type of organisation do you work for? Tick one only
Public Sector (i.e. government at any level or a recognised parastatal)
Private Sector (if you are self-employed in your own business you are not eligible to apply)
■ Civil Society (i.e. community, development or non-government organisation, faith-based organisation,
multi-lateral organisation)
Unemployed you are not eligible to apply. Please do not proceed.

Are you a citizen of Cameroon?



 Yes
 No Do not proceed: apply using the correct form for your country.
Do you currently live in Cameroon?

 Yes
 No you may be eligible, depending on your circumstances.
If NO, please provide additional details:

Do you currently reside outside Africa?


 Yes you may be eligible, depending on your circumstances.
 No
If YES, please provide additional details:

Have you applied, or are you intending to apply, for citizenship or permanent residency in Australia or New
Zealand?
 Yes not eligible. Do not proceed.
 No
Do you have Australian or New Zealand citizenship or permanent residency?
 Yes not eligible. Do not proceed.
 No
Are you engaged or married to someone who has, or is eligible for, Australian or New Zealand citizenship
or permanent residency?
 Yes not eligible. Do not proceed.
 No

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake 4
Do you have a degree (or equivalent)?

 Yes
 No not eligible. Do not proceed.
Are you currently employed, and will you return to your current employer and role?

 Yes
 No not eligible. Do not proceed.
Have you ever been subject to any criminal or civil proceedings, or are you currently facing legal action or
police charges in any country?
 Yes This will not necessarily disqualify you.
 No
If YES, provide details of criminal or civil proceedings and complete the statutory declaration:

Have you ever committed, or been involved in the commission of war crimes or crimes against humanity
or human rights?
 Yes not eligible. Do not proceed.
 No

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake 5
English Language Proficiency
Participants in Short Courses must have a sufficient level of English to be able to participate effectively in
the courses they will be attending. All applicants must provide evidence or certification of their English
language proficiency.
Applicants should provide at least one (1) of the documents listed below:
If you have completed an English test in the past 12 months, please attach a copy of the test results.
A letter from your employer certifying that English is the working language of your work unit and that you
regularly communicate in English if this is indeed the case.
A letter from a previous academic institution certifying that English was the medium of instruction for
your studies.
Other proof of previous studies where English was the medium of instruction.

Please indicate your English language competency:

 Native speaker  Very Good 


■ Good  Fair  Weak

If you were awarded a Short Course Award, what level of support (such as from a translator) do you
believe you would need to benefit fully from the course?


■ None  Occasional help to understand  Regular translation

Please indicate what other English language-related support you feel you might need:
None

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake 6
Computer Literacy
Please answer the following questions to the best of your ability. This will assist Institutions to decide
whether to provide additional tuition.
How regularly do you use a PC? 
■ Every day  Often  Occasionally  Rarely  Never

Please rate your overall computer 


■ Very good  Moderate  Weak  None
literacy:
Please indicate the software packages that you are familiar with:


✔ Word processing software (e.g. MS Word)? 
✔ Spreadsheet software (e.g. Excel)?


✔ Database software (e.g. Access, EndNote)? 
✔ Operating Systems (e.g. Windows 10)?


✔ Presentation software (e.g. PowerPoint)? 
✔ Email software (e.g. Outlook)


✔ Internet browser (e.g. Internet Explorer)? 
✔ Statistical packages (e.g. SPSS or Minitab)


✔ Other Please indicate:
SPSS package; ArcGIS 10.2; QGIS; Erdas Imagine 2014; Idrisi Selva; Studio Pro 8; Adob

Professional Memberships
List any relevant associations and organizations. These may be community, cultural, political, scientific,
professional and/or educational organisations.
1. Association Name PAN AFRICAN RESEARCH CONSORTIUM
Position Head of GIS and Remote Sensing unit.
Start date 2015-07-13
End date yyyy-mm-dd
2. Association Name African Union Club
Position Program and Project Manager
Start date 2015-11-30
End date 2018-04-30
3. Association Name Young African Leader Initiative
Position Alumni
Start date 2016-11-06
End date yyyy-mm-dd

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake 7
Scholarships
Have you previously received, or do you currently hold, a scholarship funded by Australia or another
country?
 Yes
 No
If YES, provide details:

Scholarship Name

Start Date yyyy-mm-dd End Date yyyy-mm-dd

Name of Institution

Study Country

Qualification Received

Have you previously applied for an Australian scholarship?


 Yes
 No
If YES, provide details

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake 8
Disability Inclusion and Support
People with disability are encouraged to apply.
The United Nations Convention on the Rights of Persons with Disabilities describes persons with
disabilities as including those who have long-term physical, mental, intellectual or sensory impairments,
which in interaction with various barriers may hinder their full and effective participation in society on an
equal basis with others. quitable
participation in international development is outlined in Development for All 2015-2020: Strategy for
strengthening disability-inclusive developme . This applies to offering
opportunities in education for people with disability who are eligible to apply for an award.

Do you identify as having a disability?  Yes 


■ No

If you answer yes it will not disadvantage you in the selection process. You will be given an opportunity
to identify any specific barriers and challenges that there may be in participating on the award. If you
are successful in your application and selected for an award, where ever possible appropriate
adjustments and support will be put in place so you can participate like others and benefit from the
award. By providing detailed information on your needs, appropriate support plans can be
developed and implemented with you.

If you answered YES above, please provide a short description of your disability:

If you answered YES above, how do you think that your disability may impact on your ability to
participate in the award? What adjustments or support may you require?

Gender Inclusion and Support


The Australian Government has an equal access policy for its scholarship opportunities as outlined in
(2016). To this end, Australia Awards Africa
aims to ensure that women participate equally in the program and have equal opportunities to benefit
from the Awards. Women are encouraged to apply and will be supported, as appropriate, during the
selection process and once awarded.

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake 9
PART 2: Proposed Studies
Which Short Course do you wish to undertake?

Preference 1
Increasing the development impact of Trade policy and negotiations
agricultural research
Public-Private infrastructure partnerships
Agribusiness Mineral and energy economics
Irrigation and Water Management for Local economic and social development in
Agriculture ■
extractives
Ocean Management Sustainable Fisheries Macroeconomic management for resource-
and Governance
rich countries

Preference 2
Increasing the development impact of Trade policy and negotiations
agricultural research
Public-Private infrastructure partnerships
Agribusiness 
■ Mineral and energy economics
Irrigation and Water Management for Local economic and social development in
Agriculture
extractives
Ocean Management Sustainable Fisheries Macroeconomic management for resource-
and Governance
rich countries

If selected, are you able to take leave from your workplace to undertake a Short Course for up to three
months?

 Yes
 No

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake 10
PART 3: Returning to Work
How applicants plan to use the skills acquired through their proposed studies is an important
consideration in assessing each application. Assessment will take into account the relevance of your
course choice to your current employment, and how you intend to apply your enhanced skills to benefit
your career, your employer and your nation.

Current Employment
Position title Program Manager

Select Employer Organisation:

ARPEDEL (Organisation for Research, Protection of the Environment and Local


list above:

Public Sector Rank or Designation


(public sector employees only)

Please describe your current Employment



 Executive / Senior Management/ Senior Professional
(e.g. Senior Principal, Director of Nursing or Nurse Superintendent)
 Middle Management/ Professional
(e.g. Principal, Supervising Nurse Practitioner)
 Senior Clerical or Administrative/ Technician/ Supervisory
(e.g. Specialist or Supervising Teacher, Senior or Specialist Nurse)
 Clerical or Administrative/ Tradesperson
(e.g. Semi-skilled, Graduate entry Public Servants, Graduate Teachers and Nurses) 

 Other, please indicate

Please give the number of years and months of professional Years: Months:
experience you have gained since graduating with your first 5 5
tertiary level qualification (e.g. your degree):

Employer Contact Details


Physical Address (your actual work Department of Project and Program, ARPEDEL.
unit and location):
Obobogo

Town / City: Yaounde

Province Centre Postal Code

Country Cameroon

Landline Number Main: +237 243 850 894 Other: +237 999 9999 9999

Mobile (Cell Phone) Number Main: +237 695 694 592 Other: +237 999 9999 9999

Employer Email arpedelini@gmail.com

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake 11
Sector Of Employment
What sector do you work in? Please see the Instructions for guidance, then tick the one sector that is
Please note this question
refers to the sector in which your employing organisation operates, not the sector of your profession.
So, for example, if you are an IT professional working in an educational institution, you would select
yment
Agriculture Health
 Animal-related  Public Health
 Irrigation-related  HIV/AIDS
 Plant-related  Infrastructure
 Other agriculture, specify below  Maternal / Child Health
Mental Health
Clinical Rehabilitation
 Other health, specify below
Development Studies Infrastructure
 General Development including Rural  Communications
development  Public / Private Partnerships
 Gender  Project Management
Disability Services  Energy
 Peace and Conflict  Transport
 Other, specify below  Other, specify below
Education Natural Resources Management
 Education Leadership and Management 
■ Environmental management, including climate
 Tertiary change
 Infrastructure  Extractive industries
 Curriculum Design Oceans
 Technical / Vocational Education and Training  Other productive sector, specify below
Special Education
 Other, specify below
Governance Water and Sanitation
 Public Policy (including Public Sector Reform)  Water resources management
 International Relations  Sanitation supply and service delivery
 Public Financial Management  Infrastructure
 Trade Policy  Water supply and service delivery
 Other, specify below  Regulation of water and sanitation services
 Other, specify below

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake 12
Reintegration Action Plan
Please complete your Reintegration Action Plan. This section is compulsory, and we strongly urge you
to discuss it in detail with your employer.
PART 1: Applicant’s General Expectations and Plan
Please list the skills and knowledge you expect to gain from this award. Please be as specific as possible.
Acquire knowledge and skills to assist local communities to take advantage of the resources and strengthen
the development of the communities.
Acquire knowledge and skills to assess the challenges and opportunities of mineral exploration for local
development.
Acquire knowledge and tools to assess the social and economic impacts of mining activities for local
development.
Acquire skills and knowledge to contribute to decent job creation at the local level in partnership with all the
stakeholders from the local level to the national level.
Acquire skills to defend the right of local communities to access natural resources, especially the most
vulnerable in the South and East Region who are youths, women and pygmies.
Get practical tools for supporting the local economy
Acquire knowledge to help build up a strong network for advocacy and reinforce local managerial activities in
mining sector.
Develop complex and critical thinking to solve environmental issues linked to mining sector.

development priorities, including those related to gender equality and social inclusion. Please provide
details, e.g. citing national plans, programmes or policies.
One of our main role as organization is to defend rights of local communities to access natural resources
and benefit from it; as well as the capacities building of youths and women to strengthen local communities.
with my role of program manager at ARPEDEL, I work to educate them on opportunities and benefits that
they can get from extractive industries located in their community. The issue that they are facing is high
unemployment rate (27% jobless and 75.5 underemployed: Ministry of jobs, 2016). One of the main issue
with local population is the lack of modern economic tools management and I will work to reinforce it.
According to the mining code of Cameroon (Dec 2016), communities should benefit from social investment
coming from mining activities and the government through the Growth and Employment Strategic Paper
(GESP) of Cameroon envisages the amelioration of the livelihoods of local communities and I will work with
partners to ensure that it is respected through advocacy.

Please describe how you expect to apply the skills and knowledge gained from this Award to improve
policy or practices at your current or future job.
The government is not aware of some malpractices that are going on at the level of local communities.
They rely on writing semester reports on mining communities based only on production data and local
transformation without assessing the immediate economic/social impact on the localities. this is due to lack
of a strategic development plan for local communities and corruption practices that are going on there,
making the sector dark for external partners. I will work with communities to develop and implement local
development plans, mastering of some keys texts of laws and regulations on their rights and returns from
mining activities, mapping of their natural resources located in mining permits and lastly the identification of
opportunities and challenges of mining for local economy. Simultaneously, I will engage communities and
partners in advocacy at the level of the government and companies to comply with their social
responsibilities toward communities and local economy.

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake 13
Part 2: Employer’s General Expectations and Plan
Note: This section should be completed by your employer or line manager.
Please explain what skills / knowledge you expect the Applicant to return with, and how your organisation
will use them.
The candidate works directly with local communities located in mining permit to evaluate the socioeconomic
and environmental impact of mining and extractive activities. therefore, he needs skills and tools to build the
capacities of those communities, especially youths and women to take advantage of these activities taking
place in their land. He will use the knowledge acquired to educate communities on how to participate in the
monitoring of mining activities, engaged them in advocacy for the respect of their rights, but also the respect
of the social responsibilities of extractive industries towards them and the environment. To do so, the
candidate needs good advocacy skills, and also good capacity to build network at the local and national level
to make sure that they request are reaching the right table. The candidate needs good negotiation and
reports writing skills to write good reports and help communities to get their share to develop local economy.

Part 3. Tasks or Responsibilities: Applicant and Employer


Applicants: Please consult with your employers and list up to five of the most important work related tasks
or responsibilities you expect to contribute to once you complete your Short Course Award.
A task includes any function or operational activity, including research. You can list those that you are
currently responsible for, or new tasks which you expect to undertake on your return.
(Task / Responsibility) Current New

1
Identify and assess local communities issues, economics needs, assets, opportunities ■
and threats coming from the mining sector.

2
Participate and contribute in the designing and implementation of a strategic ■
development plan for local communities in the mining sector with the stakeholders.

3
Build up a strong network with traditional leaders, youths leaders, interested groups and ■
individuals to make the voice of communities heard, but also to monitor the
implementation of social responsibilities of local industries towards local populations.
4
Carry a research on the environmental impacts of abandoned mining sites in the East ■
Region and propose remediation and compensation measures for local communities
and prepare reports and strategic documents.
5
Propose policies to stakeholders related to job creation and local transformation by ■
engaging communities in structured and well planned local mining activities.

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake 14
PART 4: Curriculum Vitae
Full Name Romaric OUABO

Address Paloma Junction

Country Cameroon

Email ouamboemmanuel@yahoo.fr Phone: +237 694 268 691


Date of Birth 1989-12-10 Current Age: 28

Study History
Qualification Name Bachelor in Physical Geography

Level of Study  Secondary  Diploma / 


■ 
(High School) Vocational/Technical Undergraduate Postgraduate
Name of Institution University of Yaounde I

State / Province Centre Region

Country Cameroon

Language of French
Instruction
Start Date 2007-09-01 End Date 2010-07-09

Status 
■ Complete  Pending results  Incomplete  Withdrawn

Qualification Name Master in Geomatic applied to Sustainable Management of Territories.

Level of Study  Secondary  Diploma /  


(High School) Vocational/Technical Undergraduate Postgraduate


Name of Institution University of Yaounde I

State / Province Centre Region

Country Cameroon

Language of French
Instruction
Start Date 2010-09-11 End Date 2012-08-21

Status 
■ Complete  Pending results  Incomplete  Withdrawn

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake 15
Qualification Name Disasters and Ecosystems: Resilience in a Changing Climate

Level of Study  Secondary 


■ Diploma /  
(High School) Vocational/Technical Undergraduate Postgraduate

Name of Institution Iversity

State / Province Online training at UNEP

Country Cameroon

Language of English
Instruction

Start Date 2015-01-08 End Date 2015-04-05

Status 
■ Complete  Pending results  Incomplete  Withdrawn

If you have received any academic awards or prizes, please provide details:
ANESI exchange program Jan. 2016, UNESCO.
Granted to travel for research exchange (on heavy metals in e-waste) to Ivory Coast.

Excellency Award from the president of Cameroon Republic from 2009 to 2011 at the University of
Yaounde I. Received prize for best students in order to encourage excellency during three years.

Employment History
Please start with your current position and work backwards

Position Title Program Manager

Employing ARPEDEL (Organisation for Research, Protection of the Environment and Local Developmen
Organisation

Location Centre

Country Cameroon

Start Date 2016-01-03 End Date yyyy-mm-dd

Duties and Achievements (Max 100 words)


- Lead and manage by motivating employees to remain optimistic in the face of challenges and to encourage
good performance and values.
- Create programs and challenges as effective and efficient as possible for the organization.
- Engage the external community to establish and maintain essential relationships.
- Guide the organization throughout the management process, build the development concept by presenting
proposals and evaluation results.
- Support and connect with the population targeted

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake 16
Position Title Environmentalist and GIS facilitator

Employing ARPEDEL
Organisation

Location Yaounde

Country Cameroon

Start Date 2014-11-07 End Date 2015-12-31

Duties and Achievements (Max 100 words)


- Assists in developing, managing and evaluating the portfolio of grants, programs and initiatives.
- Invest in building relationships, both with the external community and with the population targeted by the
NGO
- Assist in designing and implementation of field activities in environmental education.
- Trainer in Geographical Information System and Cartography during seminar in geomatics.
- Research and project writing on environmental issues such as waste management and flood in
communities.

Position Title GIS Facilitator

Employing Forest and Rural Development (FODER)


Organisation

Location East and South Regions

Country Cameroon

Start Date 2014-03-01 End Date 2014-10-31

Duties and Achievements (Max 100 words)


- Capacity building of local population
- Mapping of livelihood activities and natural resources
- Training of local cartographers
- Production of village maps
- Integration of communities data into a GIS
- Support forest communities to defend their right to access resources.

Position Title GIS and Environmentalist Intern

Employing Egis Cameroon


Organisation

Location Yaounde

Country Cameroon

Start Date 2012-11-05 End Date 2013-03-29

Duties and Achievements (Max 100 words)


- Contribution of Geomatic in the Environmental Impact assessment of road projects.
-The contribution of remote sensing and GIS in the comparative analysis of ways variants for a road project
(Nkolmetet-Zoetele).
- Implementation of a GIS for the monitoring and control of a road project infrastructure.

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake 17
Please summarize any earlier employment history here (year, position, employment organization)
Year: March to April 2014

Position: Environmentalist Consultant

Organization: Egis Cameroon

Year: Nov 2011 to Feb 2012

Position: Environmentalist/GIS intern

Organization: ERA Cameroon

Referees

Referee # 1: Given Name Gilbert

Surname Chongwain Mbzighaa

Position Deputy Coordinator of Local Mineral Transformation

Organisation Ministry of Mines, Industry and Technological Development (MINMIDT)

Contact Phone Number +237 670 352 387

Email gilmbzi@yahoo.co.uk

Referee #2: Given Name Serges Roberteau

Surname TCHOFFO

Position Cartography & GIS Database Manager

Organisation FODER (Forest and Rural Development)

Contact Phone Number +237 675 880 754

Email srtchoffo@gmail.com

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake 18
PART 5: Commitment and Support
PRINT, SIGN AND SCAN THIS PAGE

Signatures And Commitments


APPLICANT do you agree to the following commitments?
To review your Reintegration Action Plan (RAP) during your study to: 
✔ Yes  No
(a) e work plans and expectations
(b) ensure your course of study continues to support development of the
appropriate skills
Attend a debriefing session prior to the end of your Short Course or on return. 
✔ Yes  No
Complete and forward a RAP Monitoring Report to Australia Awards Africa 
✔ Yes  No
annually for a three-year period after return. Note: a reporting template and guidelines will be
provided by Australia Awards Africa.

Participate in case studies and other evaluations to inform Australia Awards of the 
✔ Yes  No
development effectiveness of the Australia Awards Africa Program
Maintain up to date contact details on the Australia Awards Alumni data base and 
✔ Yes  No
participate in Alumni activities after returning from your studies
I certify that with the exception of of the Reintegration Action Plan above, I
completed this application personally and that the information I have provided is true and accurate. I
understand that if I have provided false or misleading information my application may be disqualified and I
may be subject to investigation for fraud. If offered I agree to abide by the conditions of the award.
Signature Date

EMPLOYER do you agree to the following commitments?


Support the candidate to implement the Reintegration Action Plan as developed 
✔ Yes  No
above
Develop a plan on how the candidate will work with colleagues to transfer their 
✔ Yes  No
knowledge
continuing involvement in Australia Awards Alumni 
✔ Yes  No
activities
Participate in and support Australia Awards monitoring and evaluation activities 
✔ Yes  No
What is your work relationship with the candidate? Professional

How long have you known the candidate professionally? 4 years

Do you support the candidate in their application for this award? 


✔ Yes  No
Employer Name and Position: Tsikam Mba Cyrille
Chairman of the Board of Directors at ARPEDEL

Employer Signature Date


(and stamp if available)

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake 19
PRINT, COMPLETE, SIGN AND SCAN THIS PAGE
Applicant’s Declaration and Signature
Authorisation
DFAT must comply with the Privacy Act 1988 in relation to the personal information you have provided in this form.
By submitting this form I authorise DFAT, or its appointed managing contractor, to access and/or obtain information,
including copies of any of my relevant academic records/reports from the education institution(s) that I have
attended for the following purposes:
 for use in the selection process for an Australia Award
 to monitor my academic performance at my host institution while studying under an Australia Award
 to brief relevant Australian officials, Ministers and members of Parliament.
I also consent:
a) to the Australian Government using and disclosing extracts of my application (relating to my academic
background and achievements, leadership skills and my proposed study program in Australia) in promotional
material in hardcopy and on the Internet. I note that promotional material may include, but is not limited to,

concerning the Australia Awards.


b) to my personal information and that of my family members and dependants, including sensitive information as
defined in the Privacy Act 1988, being collected, handled, used and disclosed by and exchanged between
DFAT, other government agencies including Australian immigration authorities, Australian education
institutions, partner organisations (including managing contractors and sub-contractors), medical insurers,
medical practitioners, case managers, my home government and other parties, in the circumstances outlined,
and for the purposes indicated, in the Short Course Award Handbook as updated from time to time.
I authorise DFAT to disclose the personal information collected in this form to other Australian Government
departments and Australian education institutions for the purpose of promoting and managing the Australia Awards.
I understand that DFAT will treat all details of this application as confidential except as authorised herein.
Understanding
I understand and confirm that:
 I have read and complied with the Short Course Award Handbook and that the contents of my application are
true and correct
 DFAT has the right to vary or reverse any decision regarding a scholarship made on the basis of incorrect or
incomplete information
 Decisions of the selection panel are final and confidential and no correspondence about outcomes of the
selection process will be entered into.
Agreement
If successful in gaining an Australia Award, I agree that I will:
 undergo a police or character check before my Australia Award is confirmed
 immediately provide DFAT with details of any incident that may reflect badly on the prestige of an Australia
Award
 act in a manner befitting a recipient of an Australia Award
 use the funds for the purposes granted
 acknowledge the assistance given by the Australian Government in any written reports, publications or publicity
associated with the Award.
Declaration and acknowledgement
I declare, in submitting this application form, that the information contained in it and provided in connection with it is
true and correct.
I acknowledge that giving false or misleading information is a serious offence under the Criminal Code Act
1995 of the Commonwealth of Australia .

Name

Signature Date

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake 20
Feedback Information
How did you first find out about Australia Awards Short Courses?
Email Brochure
 Australia Awards Alumni  Australia Awards Alumni
 Australia Awards Africa 
■ Employer

 Employer  Alumni Association

Media Event
 Newspaper advertisement  Australia Awards Event (please specify)
 TV or Radio program  Other Event (please specify)

Social Media Digital Media


 Facebook  Australia Awards Website
 Twitter  Other Website (please specify)
 LinkedIn  Facebook Adverts
 Google Adverts

Please specify here:

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake 21
Submit Your Application
Submission Checklist

Please note that any applications that do not attach the required supporting documents, or that do not
meet all the submission requirements listed below will be treated as non-compliant and may be
disqualified.
Note: The interactive features of this page may not function in all PDF Reader software. For further
information, please refer to
http://www2.adsafrica.com.au/FormRequest/technical_tips_and_advice.pdf

Step 1: Submission Requirements


All relevant fields in this Application Form completed. 
Questions must be answered in the spaces provided in the Application Form. Answers provided on
separate sheets or in any other format will not be accepted.
Click to check for completeness 

Reintegration Action Plan Part 2 completed by your employer. Mandatory. 
Click to check for completeness 

Signatures and Commitments page completed and signed by you. 
Signatures and Commitments page completed and signed by your Employer.
Click to print Signatures and Commitments 

Signed and scanned? 

Declaration and Signature completed, signed by you and witnessed. 
Click to print 

Signed and scanned? 

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake 22
Supporting Documents
Please tick each item that is attached to your application.
Passport. Copy of data page, including photo, must be provided.


. Mandatory for all applicants.


. Copy of certified transcript is mandatory for all
applicants.


English Language Proficiency
One or more of the following must be provided by all applicants.
IELTS, TOEFL or PTE test results

Letter from Employer certifying use of English in the workplace.


Letter from university of your Bachelor degree confirming English as language of instruction.

Other Tertiary Certificate. For studies (longer than 3 months) undertaken since finishing your
Optional.


Other Transcript of Results. For studies (longer than 3 months) undertaken since finishing your
Optional.


Performance Reports from your current employer. Optional.


Letter of support from your employer, indicating that you will be available and allowed to attend
the Short Course, and that your salary will continue to be paid while you are studying. Optional.


Step 3: Submit this Application Form
If you are using a desktop email system, you may use the Send button below to create an email message
to Australia Awards Africa with your application form already attached.
Alternatively, you can
 Save the form
 manually create an email message in your desktop email or web-based email system,
 attach the saved form, and
 send to applications@adsafrica.com.au.
Click to send your application 

Australia Awards Africa Australia Awards Africa Short Course Award Application Form: 2018 Intake 23

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