E-mail(primary/official mail) 2019 PROGRAM APPLICATION FORM Seoul Human Resource Development Center(SHRDC) Metropolis International Training Institute Headquarters Attach Your Scanned Photo Nambusunhwan-ro 340-gil 58, Seocho-gu, Seoul, 06756, Korea Phone: +82-2-3488-2059~2060 Fax: +82-2-3488-2346 Web : http://hrd.seoul.go.kr/shrdc E-mail: shrdcinfo@gmail.com Note: Please type in the form in English alphabets or tick(√ ) “N/A” should be used where applicable. Do not leave any space blank. Ⅰ. PROGRAM TITLE : Ⅱ. PERSONAL DETAILS - First Name: - Middle Name: - Last Name: (Exactly same name used on your passport – This name will be used on your certificate of completion) Date of Birth City/Locality Nationality Gender Religion Day Month Year DD MM YYYY □ Male □ Female E-mail(primary/official mail) E-mail(secondary) Office Phone (country code) - (city code) - (number) Mobile Phone Emergency Contact Name: (Relationship: ) Emergency Contact Number: (country code) - (city code) - (number) Dietary Restrictions, Food Allergies and Religious Restrictions Please describe any dietary or religious restrictions (i.e Vegeterian, Halal ) or any food allergies ※ VISA: I need an invitation letter to apply for entry visa issuance. Yes ( ) / No ( ) Participants may need to obtain an entry visa to the Republic of Korea from the Embassy or Consulate in their respective country before commencing their journey (at least 2 weeks). Participants are responsible for getting their visa. For more information about entry visa to Korea please visit https://www.visa.go.kr/ 2019 PROGRAM APPLICATION FORM

Ⅲ. ORGANIZATION INFORMATION & TRAINING EXPERIENCE • Present Job Title: • Department/Division: • Name of City/Local Government/Organization: • Office Address: • Official Website Address of your City/Local Government/Organization: • Type of Organization *Please tick(√) the box. City/Local Government ( ) Autonomous Institution of City/Local Government ( ) Other (please specify : ) • Term of Employment: from ( ) to present • Description of Your Current Duties / Responsibilities: Training experiences in Korea during last 5 years Yes( ) / No( ) If “Yes,” Please Specify Title and Period of Program : Organized by : Other International Training experiences during last 5 years (not in Korea) Yes( ) / No( ) If “Yes,” Please Specify Ⅳ. ENGLISH PROFICIENCY *Please tick(√) the box. Native Excellent Fair Poor Remarks Listening (i.e. English test score) Speaking Writing Reading Native Language: ( ) Other Languages: ( ) 2 of 5 2019 PROGRAM APPLICATION FORM

V. STATEMENT OF MOTIVATION AND WHAT YOU WANT TO LEARN 1 Knowledge/ Technology Level In your opinion, on a scale from 0 to 10, what is the knowledge/technology level of your city and Seoul in regards to the training subject *Please tick(√) the box. (For example, in e-Government field, internet penetration ratio can be used as benchmark) 1(Low) 5 10(High) 1(Low) 5 10(High) 2 Please state your training goals. How will your participation benefit your career and/or your city/organization? 3 Please specify what would you like to learn from the training? (The training curriculum is not finalized and subject to change. You also can state particular themes of lectures or site visits that you would like to propose for the curriculum.) 4 What is the major policy and pending issue of your city/organization in regards to the training subject? 5 If there are pending issues, what are the main obstacles? 3 of 5 2019 PROGRAM APPLICATION FORM

APPLICANT'S RESPONSIBILITIES If accepted as a participant, I agree: To follow and to prepare 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 city and organization; To accept that the SHRDC shall reserve the rights for the materials that have been generated & submitted for the training purpose, SHRDC is not liable for any damage or loss of personal property; 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. Not to absent or skip training course for any personal matters. Date (dd/mm/yyyy) : Name of Applicant : Signature : 4 of 5 2019 PROGRAM APPLICATION FORM

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 Job Title : • Department / Division : • Name of City / Organization : Recommender’s Profile • Recommender’s Name : • Recommender’s Relation to Applicant : • Department/Division : • Name of City/Local Government/Organization : • Official Website Address of City/Organization : • Contact Information - Tel : - E-mail : (We may contact you during applicant selection process) Date(dd/mm/yyyy): Signature: 5 of 5 2019 PROGRAM APPLICATION FORM