SELF Application Form

NOMINATION FORM
School for Ecumenical Leadership Formation 2001
July 15 - August 19, 2001, Thailand

Name				(M/F)

Date of Birth					P
	( D D / M M / Y Y )				H
Correspondence					O
Address					T
					O

Contact	Telephone	(	)
	Fax	(	)
	E-mail
Academic
Background

		major	Year		University


Working
Experiences		Nature of work	Employer
SCM Position

Brief description of involvement and activities in the SCM



Brief description of your vision on the SCM and the Ecumenical Movement



Nominated by			Signature


Endorsed by
SCM Chop


Submitted To	World Student Christian Federation, A-P Region
	Unit 1-2, 18/F, 280 Portland St.Commercial Bldg.
	280 Portland St., Mongok, Kowloon, Hong Kong
	Tel : (852)23852550 Fax : (852)27823980
	E-mail : wscfap@asiaonline.net
Deadline	March 20, 2001

Please send this form to the SCMA office in the first instance and also fill in the SCMA Covering Form as well. Do not send to WSCF-AP directly!