Summer University On-Line Application

APPLICATION FORM / FORMULAR APLIKIMI

Please fill in all fields in order for your application to be considered!
Ju lutem mbushini te gjitha fushat qe aplikimi juaj te konsiderohet!

I. APPLICANT’S PERSONAL DATA / TE DHENA MBI KANDIDATIN

Name / Emri
Surname / Mbiemri
Address / Adresa
City / Qyteti
Country / Shteti
Phone / Tel
Mobile Phone / Celular
Email / Email
Birthday / Datelindja
Place of birth / Vendlindja
Occupation / Profesioni
Education / Edukimi
Working place / Vendi i Punes
Organization or political group where you adhere / Organizata apo grupimi politik ku jeni anėtar/aktivist
Type of organization / Lloji i organizatės	local / lokale regional / rajonale national / kombėtare European/International /ndėrkombėtare
Your position in this organization or political group / Pozicioni qė keni nė kėtė organizatė a grupim politik
List the similar activities where you have taken part / Nė ēfarė kualifikimesh tė kėtij lloji keni marrė pjesė

II. MOTIVATION OF PARTICIPATION / MOTIVIMI I PJESĖMARRJES

Why do you want to take part in this Summer University / Pėrse do tė donit tė merrnit pjesė nė kėtė Universitet Vere
How do you think that the participation in this session will assist you in your present work? / Pėrse mendoni se pjesėmarrja nė kėtė Universitet Vere ju ndihmon nė punėn tuaj aktuale?
How will it assist you in your future activities / Pėrse mendoni se pjesėmarrja nė kėtė Universitet Vere do t’ju ndihmojė nė angazhimet tuaja nė tė ardhmen?

III. EXPECTATIONS FROM YOUR PARTICIPATION IN PROJECT / PRITSHMĖRIA NGA PJESĖMARRJA JUAJ NĖ PROJEKT

How will the topics discussed in this summer university assist you in the future? / Ēfarė do tė dėshironit tė zhvillohej nė programin e Universitetit tė Verės sipas specifikes sė angazhimit dhe fushės sė interesit tuaj?
What specific topic related to your area of interest would you like to be discussed in this session of the summer university? / Ēfarė do tė dėshironit tė zhvillohej nė programin e Universitetit tė Verės sipas specifikes sė angazhimit tuaj?
What would be your preliminary suggestions regarding the summer university program? / Ēfarė do tė do sugjeronit paraprakisht rreth programit tė Universitetit tė Verės? (pas njohjes me programin e aktiviteteve)

IV. ATTACHMENTS / ANEKSE

Curriculum Vitae (text) / Curriculum Vitae (teks)
Essay (Your point of view regarding one on the main themes (session) of the SU programme). No less than 200 words. / Ese (200 fjalė) Tema: Kėndvėshtrimi tuaj mbi njė nga temat e sesioneve qė do tė trajtohen nė UV.
Recommendation 1/ Rekomandim 1 (One recommendation should be from your employee or director of organization/political forum where you take part. In both cases you send the application via email write also the name of persons as well as their telephone number.) (Njė tė jetė mundėsisht drejtuesi i organizatės/forumit politik ku bėni pjesė. Emri i personit si dhe numrin i telefonit.)
Recommendation 2/ Rekomandim 2 (One recommendation should be from your employee or director of organization/political forum where you take part. In both cases you send the application via email write also the name of persons as well as their telephone number.) (Njė tė jetė mundėsisht drejtuesi i organizatės/forumit politik ku bėni pjesė. Emri i personit si dhe numrin i telefonit.)

V. OTHER INFORMATIONS / INFORMACIONE TĖ NEVOJSHME

• 85 % obligatory participation in lectures and discussions.
• Successful students receive a graduation DIPLOMA after completing an essay relevant to themes of the program at the end of the Summer University. Participants complete the final versions of their essays during October-November and diplomas will be distributed at the end of December.
• The program of SU and the accommodation of the participants will be done on the New York Hotel in Vlora.
• Accommodation (meals incl.) are covered.
• All participants have to pay a mandatory participation fee of EUR 100.

• Ndjekja e leksioneve do tė jetė e detyruar sė paku nė masėn 85%.
• Dhėnia e DIPLOMĖ-s pėr pjesėmarrėsit do tė kushtėzohet me pėrgatitjen e njė eseje rreth temave tė UV ose derivateve tė tyre, tė cilat do tė vlerėsohen nga njė juri e posaēme.
• Programi i Universitetit si dhe akomodimi i pjesėmarrėsve do tė bėhet nė Hotel New York - Vlorė.
• Shpenzimet e akomodimit (ushqimit) mbulohen nga organizatorėt.
• Pjesėmarrėsit qė do tė pėrzgjidhen, duhet tė paguajnė pėr pjesėmarrje 100 Euro.

Please take note of the following conditions that will apply if you are selected to take part at the summer university. 1. I commit myself to participate actively in the whole process, including: - to prepare myself carefully for the Summer University and to do all remote preparation work the organizing team will ask for, - to take part in the full duration of the Summer University (participation in 85 % of lectures and discussions is obligatory), - to participate in the whole evaluation process, - to prepare a final paper related with the program of the 7th Edition of the SU, and send it by November 24, 2009. 2. I am aware that obtaining a health and a full travel insurance are my own responsibility and at my own expenses. I understand that the information I provided on my special needs does not remove my own personal responsibility for ensuring my own health. 3. I authorize KRIIK Albania Association to publish (my correspondence address, information about my organisation and work, any material produced during the SU (including the final paper) as well as pictures taken during the SU), in the official website of the organization and in other materials related to the Summer University.

Nėse pėrzgjidheni si pjesėmarrės, ju pranoni apriori se:

1. Angazhoheni tė merrni pjesė aktivisht nė tė gjithė procesin para, gjatė dhe pas realizimit tė programit, duke pėrfshirė: - pėrgatitjen paraprake qė mund t’u kėrkohet nga stafi i UV. - pjesėmarrjen aktive gjatė gjithė kohėzgjatjes sė Universiteti tė Verės (pjesėmarrja nė leksione dhe diskutime ėshtė e detyrueshme nė masėn 85 %). - pjesėmarrjen nė procesin e vlerėsimit nė pėrfundim tė UV. - pėrgatitjen e esesė pėrfundimtare, nė lidhje me temat qė do tė trajtohen gjatė programit tė Universitetit tė Verės, dhe dorėzimin e saj deri mė datėn 24 Nėntor 2009. 2. Sigurimi i jetės dhe i udhėtimit gjatė periudhės sė pjesėmarrjes nė UV ėshtė pėrgjegjėsi dhe kosto personale e juaja. Informacionet qė keni dhėnė mbi nevojat tuaja tė veēanta ushqimore apo shėndetėsore, nuk e largojnė pėrgjegjėsinė tuaj mbi sigurinė e shėndetit tuaj. 3. Autorizoni organizatėn KRIIK Albania qė tė publikojė tė dhėnat tuaja (kontaktet, informacione mbi punėn dhe organizatėn qė pėrfaqėsoni, ēdo material tė prodhuar gjatė zhvillimit tė Universiteti tė Verės (pėrfshi esenė finale) si dhe fotografitė e marra gjatė zhvillimit tė UV) nė website-in zyrtar tė organizatės si dhe nė materiale tė tjera publikuese qė lidhen me UV.

No, or only partial reimbursement of travel costs. Please specify the kind of reimbursement you expect:
/ Shpenzimet e transportit nuk mbulohen, ose do tė mbulohen pjesėrisht. Ju lutem specifikoni nese keni nevojė pėr rimbursimin e shpenzimeve tė transportit:

No / Jo
Yes, partially / Po, pjeserisht

Visa's cost will be reimbursed. Please specify if you need a visa to enter in Albania:
/ ? Pėr pjesėmarrėsit nga jashtė Shqipėrisė, do tė rimburohet pagesa e vizės. Lutemi specifikoni nėse keni nevojė pėr vizė pėr tė hyrė nė Shqipėri:

No / Jo
Yes / Po

Do you have any special needs (please indicate any health or dietary details)? / ? Nėse keni nevoja tė veēanta, lutemi specifikoni?