Application Form South Asia Peace Workshop 2012

Name: Mr
Title

Farrukh Amin
Given Name/First Name

Raja
Surname/Family Name:

Details: 16th April 1970

Date of Birth

Male
Male/Female

Pakistan
Citizenship

Humanitarian Islam
Religious Affiliation

Rajpoot
Tribe/Ethnic Community

Education: MA Political Science (International Relations)

Degree/Qualification

Islamia University, Bahawalpur

Institution

1993

International Law International Relations (click tab for more rows)

List a few Core Courses

Year of Graduation

Work Experience: Editor-in-Chief

Position

Daily The Statesmen www.TheStatesmen.Net

Organization

10 Years (click tab for more rows)

Years Worked

Volunteer Work:
Please describe any volunteer work that you have been involved with. Include organization names and dates involved.

I am a Poet, Freelance Writer & Political Activist, advocating socio-economic justice for an egalitarian / classless society in Pakistan. Founder Chairman of Ibn-e-Umeed Foundation with its subsidiaries like Pakistan Policy Institute and LIPS (Lobbyists for International Peace & Socio-Democratic Rights) besides being Founder of Hum17Crore.Org & We99Percent.Org (Striving for a pro-change progressive mass-mobilization).

Language Skills:
Please indicate the languages you are familiar with and your proficiency by filling in Excellent, Good, Average or Poor.

Language English Urdu (Hindi) Punjabi Contact: +92-331-493-9983

Phone number

Reading Excellent Excellent Average

Writing Good Good Poor

Speaking Good Excellent Good

ibn.e.umeed@gmail.com, editor@thestatesmen.net
Email

H # 474, Pak Block, Allama Iqbal Town, Lahore-54570, Pakistan

Street Address

LAHORE
City

Punjab
State

54570
Zip/Postal Code

PAKISTAN
Country

Emergency Contact: Mrs Farrukh

Name

Wife
Relationship

+924235090637
Phone number

visa.careers2011@gmail.com
Email

Funding:
If sponsored

N.A.
Name of Sponsoring Organization or Individual If not sponsored how you do plan to pay the course fee?

N.A.
Amount

Myself Fees: Payable to the Henry Martyn Institute: Cheque: Money Order: Demand Draft: If DD: Payable later
DD No. Bank Amount

Put an X in the appropriate box.

Once completed send this form by email to hmi.sapw@gmail.com. Henry Martyn Institute: International Centre for Research, Interfaith Relations and Reconciliation. 6-3-128/1 Beside National Police Academy, Shivarampally, Hyderabad 500 052, A.P., INDIA. Phones: (91-40) 24014231, 24014258, Fax: (91-40) 24014565 Website: www.hmiindia.com

Name:

Statement of Purpose:
Please write your statement of purpose in a maximum of 2 pages or 1000 words. Some guiding questions to follow are. Why do you want to participate in this SAPW2012? What personal or professional goals do you aim to achieve through this workshop? How will this workshop benefit you and what will you do upon completion of this workshop?