SNS(facebook, twitter, qq) PROGRAM APPLICATION FORM Attach Your Scanned Photo Seoul Human Resource Development Center Metropolis International Institute Headquarter Nambusunhwan-ro 340-gil 58, Seocho-gu, Seoul, 137-071, Korea Phone: 82 2 3488 2059 Fax: 82 2 3488 2346 Web : www.seoulmiti.org or www.metropolis.org/MITI E-mail: shrdcinfo@gmail.com Note: Please type in the form in English alphabets or tick(√ ), do not in hand-write for legibility “N/A” should be used where applicable. Do not leave any space blank. Ⅰ. PROGRAM TITLE : Ⅱ. PERSONAL DATA : (First) (Middle) (Last Name) Date of Birth City/Locality Nationality Gender Religion Day Month Year M ( ) / F( ) e-mail Office Phone SNS(facebook, twitter, qq) Mobile Phone Emergency Contact Name : Emergency Contact Number : (country code) (area code) Dietary Requirements : ※I don’t eat ※ VISA: I need an invitation letter to apply for entry visa issuance. Yes ( ) / No( ) Ⅲ. EMPLOYMENT AND EDUCATION Present Position/Title: Department or Division: Name of Organization: Address: Type of Organization: - City/Local Government ( ) - Autonomous Institution of City/Local Government ( ) - Other ( please specify : ) Term of Employment: from ( ) to present

Ⅲ. EMPLOYMENT AND EDUCATION (Continued) Describe your present duties : Training experiences in Korea (if any) Yes ( ) No ( ) If “Yes” Please Specify Name and Period of Program : Organized by : Ⅳ. ENGLISH LANGUAGE PROFICIENCY *Please tick(√) the box. Excellent Good Fair Poor Remarks Listening Speaking Writing Reading Mother Tongue : Other Languages: V. STATEMENT OF MOTIVATION AND WHAT YOU WANT TO LEARN 1. State your motivation to participate in this training program: 2. Describe your expectation from this program :

APPLICANT'S RESPONSIBILITIES If accepted as a participant, I agree: To follow the training program to the best of my ability and abide by the rules of the SHRDC during the training program; To refrain from engaging in political activities, or any form of employment for profit or gain; To return to my home country upon completion of my training program and to resume work in my country; To accept that the SHRDC is not liable for any damage or loss of my personal property; and To acknowledge that the SHRDC will not assume any responsibility for illness, injury, or death arising from extracurricular activities, willful misconduct, or undisclosed pre-existing medical conditions. To copy, transform and redistribute the submitted documents in any medium and format. Applicant's Name: Date : Signature:

LETTER OF RECOMMENDATION Dear President of SHRDC: Upon understanding goals and objectives of your international training program and with the hope of promoting our knowledge and experience exchanges, I hereby recommend the following person as our city’s representative in your program. I guarantee that our applicant will abide by all laws and rules of your city during the program period and will resume his/her job upon completing the course. Applicant’s Profile • Name of Training Program : • Applicant’s Name : • Present Position : • Department or Division : • Name of Organization : Recommender’s Profile • Recommender’s Name : • Contact Information - Tel - E-mail (We may contact you during applicants’ selection process) Date: Signature: