Scribd Logo
Upload

Welcome to Scribd!

  • Or Mr. Velasquez

    Uploaded by

    fernando
    15 views15 pages
    Solicitud para JiCA

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    Solicitud para JiCA

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    15 views15 pages

    Or Mr. Velasquez

    Uploaded by

    fernando
    Solicitud para JiCA

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 15
    Japan International Cooperation Agency EON ETDENTIA Wee Re This guideline explains how to apply for the Knowledge Co-Creation program (KCCP) of the Japan International Cooperation Agency (JICA) under the Official Development Assistance Program of the Government of Japan. Please complete the Application Forms according to the guideline. For additional information, please consult the JICA Office, or in its absence, the Embassy of Japan in your country. Form Filled by Form1. Official Application Form + To be filled by you and your supervisor* To be signed by your supervisor Official stamp of your organization is needed. Form2. Nomination from the Organization _| You and your supervisor * Forms. Individual Application Form You Formé. Questionnaire on Medical Status | You and Restrictions FormS. Terms and Conditions, and You Declaration “Supervisor: the head of the departmentidivision of your organization Please be advised: (@) To carefully read the General Information (Gl) of the KCCP, (b) To fill only in typewritten except for signature, (©) To fill in the form in English, (d) To use “V" or “x” to mark the (_ ) options, (€) To attach your photographs, (f) To prepare document(s) described in the GI and/or confer with the JICA Expert or JICA overseas office, and attach these documents to the completed Application Forms, In submitting the Application Forms and attached documents, please make sure: (g) To prepare a copy of your passport, (h) To confirm the application procedure stipulated by your government, () To submit the original Application Forms with all necessary document(s) to the responsible organization of your government according to its application procedure, and () That your participation may be denied, if you fall to provide all required information and. documents completely and on time. ~ 2) ICA Japan International Cooperation Agency J ps peranon £9°°°Y CONFIDENTIA! CHECK LIST before submission: Items Form No. _ | Check 4. Fill n all items in typewritten Alllthe forms. 2. Your signature Form 3, 4, 5 3.__ Signature of your supervisor* Form 1,2 4, Official stamp of your organization Form 1 5._ Your photo Form 3 6. Attach a copy of passport (Machine Readable Zone) - “Applicants from Latin American and the Caribbean Countries, please refer to the note below. 7._Attach the required document(s) as instructed in the GI : “Supervisor: the head of the departmentidivision of your organization Note for Applicants from Latin American and the Caribbean Countri (1) Ityou are from any of the countries listed below and have a passport with a valid U.S. vi please attach herewith a copy of Identification Pages on the inside cover of your passport (Le. the two pages that include your photograph and detailed passport information), and the page of U.S. visa: ‘Antigua and Barbuda, Argentina (only Japanese descendants), Barbados, Bolivia, Brazil, Chile, Colombia, Dominica, Ecuador, Grenada, Guatemala, Guyana, Haiti, Mexico, Peru, Rep. of Dominica, St. Christopher and Nevis, St. Lucia, St. Vincent and the Grenadines, Suriname, or Venezuela. (2) Ifyou are from any of countries listed below and have a passport without a valid U.S. visa, please attach herewith a copy of Identification Pages on the inside cover of your passport (Le. the two pages that include your photograph and your detailed passport information). Belize, Costa Rica, El Salvador, Honduras, Jamaica, Marshall, Micronesia, Nicaragua, Palau, Panama, Paraguay, Trinidad and Tobago, and Uruguay. ~ 2) JICA Japan International Cooperation Agency CONFIDENTIA ‘Application form forthe JICA Knowedge Co-Creation Program: Form1. OFFICIAL APPLICATION FORM “To bo signod by your supervisor (tho head of the relevant department / division of your organization). 1. Course Title (as shown in the Gl) Construccién de “Marca Territorial” para Revitalizacion Comunitaria en los paises latinoamericanos 2. Course Number (the number as “xooooeoa.1xx “shown in the Gi) 202107823-J001 3. Course Duration From |___ Agosto 2 to|__Agosto31_| (DD/MIM/vyYY) 4. Country Honduras 5. Organization Alcaldia Municipal de Cantarranas 6. Name of the Nominee(s) 1)Ferando Jose Diaz Velasquez 3) 2) 4) 7. Confirmation by the organization in charge Our organization hereby applies for the Knowledge Co-Creation Program of the Japan International Cooperation Agency and proposes to dispatch qualified nominees to participate in the programs. Date: 07-junio-2022 signature: | Merce Name: Marco Antonio Guzman Title / Position Alcalde Municipal Official Department / Division _ Alcalde Stamp Adress: Cantarranas, Francisco Morazan, media cuadra aba Office Address and —_del parque central Contact Information "ei 95852710 Ema Fax mauzmand&20@gmai.com (ifnecessary) Confirmation by the organization in charge {have examined the documents in this form and found them true. Accordingly, l agree to nominate this person(s) on behalf of our government. Date: Signature: Name: Official Stamp Title / Position ~ 2) JICA Japan International Cooperation Agency CONFIDENTIA Department / Division ‘Application form forthe JICA Knowledge Co-Creation Program Form2. NOMINATION FROM THE ORGANIZATION “Tobe signed by your supervisor (the head of the relevant department division of your organization). 1, Reason for nominating the Applicant Please describe the reason(s) why the Applicant was selected, referring to the following points; 1) Program requirement, 2) Capacity/Position, 3) Future plan to be done by the Applicant after the KCCP, 4) Future plan of your organization and 5) Others. Se considera que debido a las multiples actividades que el desempefia en el area de supervision de proyectos, es importante que adquiera todos los conocimientos posibles que puede ofrecer JICA. Ademas, el ha tenido acercamiento a los grupos organizados como patronatos a los cuales puede orientar mas facilmente al tener la oportunidad de recibir este curso, 2. Expectation and Future Plan of Actions Please describe how your organization shall make use of the expected achievement of the Applicant after the program, in addressing the said issues or problems. Se espera que con el curso recibido el pueda tener mas facilidad para transmitir a los grupos ideas de mejora continua en los procesos de emprendimiento, arte y cultura de la comunidad. Actualmente, Cantarranas esta implementando la revista ONPAKU la cual es una impresion de todos los atractivos con los que cuenta la comunidad por lo que es una oportunidad que el pueda recibir este curso y asi poder brindar mejores ideas en este nuevo proyecto de turismo. By nominator (head of relevant departmentdivision) Date 07 junio-20222 Name and Title/Position Marco Guzman Alcalde Municipal Signature Marco Guzman ‘Application form forthe JICA Knowledge Co-Creatlon Program: ~ ® jica/ Japan International Cooperation Agency ONFIDENTIAL| Form3. INDIVIDUAL APPLICATION FORM “To be filed by Applicant. 4. Course Title: (as shown in the Gl) Construccién de “Marca Territorial" para Revitalizacion Comunitaria en los paises latinoamericanos iD 2. Course Number: (the number as “sooccoo00o0e “shown in the Gi) 202107823-JO01 3. Personal Information on Applicant 1) Name of Applicant (as shown in the passport) “Please type the name as shown in the passport carried. The information will be used for fight arrangements. Family Name /Surname oft Jalz Iv Je lt JaJs Jofule [z First Name Fle[R[n[a[n[bd]o ‘Middle Name J[o[s[e 2) Nationality (as shown in the passport) 3) Sex (0X) Male () Female Month noe Date Yoar (as of the dato of (ex. April) 4) Date of Birth the form) 15 Agosto 1991 30 5) PassportiVisa Passport possession ]( )Yes | (X)No | Expiry date Date | Month | Year USAvsa possession” | (ves | ONO | ofPasspert oz junio | 2022 “Applicants from Latin American and the Caribbean Countries only 6) Contact Information ‘Address: Cantarranas, Francisco Morazan, dos cuadras abajo del parque central Private TEL" Mobile®: 9609-9225 FAX" E-mail: erando19912016@gmail.com Address: Office TEL” Mobile® FAX: E-mail Emergency Name: Roxalva Yanet Lainez ~ 2) JICA? Japan international Cooperation Agency ‘ONFIDENTIAL| Contact| Relationship to you: Hermana ‘Address: Villanueva, Cortes, Colonia La Gran Vila TEL” Mobile*: 8816-1605 FAX" E-mail =Piease fil it out from country code for telephone, mobile, and fax number. 7) Present Position Organization Alcaldia Municipal de Cantarranas. ‘Year that entered the organization a Department / Division | Unidad Tecnica Municipal Title ‘Supervision de proyectos From No. of years of Years Ne service in the present {Monte position Cinco meses Febrero 2022 ( ) National Government (X) Local Government (__) Public Enterprise Type of Organization | ( ) Private (profi) ( ) NGO/Private (Non-profit) (_ ) University () Other Number of employees | 21 Home Page Address | Cantarranas, frente a parque central [Questionnaire on Relationship with the Military] “If your organization andlor your status is related to the Military, please mark with V or X below in the (_ ) which best describes the relationship. () the Miltary, an active military personnel or a military personnel sted in the muster rol/miltary register (.) an organization affiliated with the Miltary, of a personnel who does not belong to the military at present buts listed in the muster rollmilitary register (.) the Department or the Ministry of Defense, an organization affliated with the Ministry of Defense, or staff of the Ministry of Defense (.) ancivilian organization but with military personnel or a military division within the organization (.) an organization which will be affliated with or under the control of the Military in times of emergency as ‘specified clearly in its organic lawlaw of establishment Experience and Eligibility 1) Career Background (After graduation and before taking the present position) *Only Applicants for KCCP (Group and Region Focused) are requested to fill n this part. Pariod (Grgenteation couvty | Fm TD ean piacog | Btet Job Description ‘Supervision de elementos Agosto — | Marzo aos Mara Siperinon de trate | ext superitn de Constructora Medina Y Asociados | Honduras —~ oo) JICA? Japan international Cooperation Agency ‘ONFIDENTIAL| ae sg | Esmoree BOT Ta ‘Septiembr | Supenision '° | brindar —adecuacion a one roy vere [ona |S | Slots cance | Mit” nas fore seve & ‘ada wine Fatwo [ve Vous srnmnion depress | Eien, poe ous baad foo sociales, de turismo, ete 2) Academic Background (University, College or Higher Education) Pad rnstuton | 51! | Faw |e agro Major sermon | wotiew Ferro | Novertre soa EeclaFacicoForwa | vores | Ie | Nowe | rao rina Pina Fao | novo cate naon ae rttiouronyxtezo | vores | 68 [Nove | raged vcnin | BAP Ud nso! Arona rei | weno mri vows | Fete [maze | aten oper i 3) Experience of Training or Study in Foreign Countries (including all the training experience in JICA’s programs) “Only Applicants for KCGP (Group and Region Focused) are required to fill in this part. wnotntion | (8! | ree Feld of study Program Tle eee | wear 4) Language Proficiency (Self-Assessment) 1) Language to be used in the course (as shown in Gl) Usting cnesoaen | ¢ yoo | Cora | Cra Speatg ee readg opescten | ( yo000 | (Poe waiting () Excellent (Good (Fair ( ) Poor Language Test Ses any (ox TOEFL, TOG ee) 2) Mother Tongue Espanol sonra jescamm | (peo | (Poe Excellent Refined fluency skills and topic-controlied discussions, debates & presentations. Formulates strategies t0

    You might also like