ASSOCIATION OF POWER UTILITIES OF AFRICA AFRICAN NETWORK OF CENTERS OF EXCELLENCE IN ELECTRICITY (ANCEE) ANCEE Scholarship Application Form January 2017 ANCEE Scholarship Application Form – Round 3 IMPORTANT REMINDERS FOR THE HEADS OF HUMAN RESOURCES 1. Scan and email the completed and signed form with the two supporting documents required for each applicant. 2. Gather the records of each candidate (scanned forms and supporting documents) in a .PDF file clearly identified with the initials of your company and the name of the applicant. Example: "Initials of the company_Name of applicant.pdf" Make sure the electronic records are readable and the pages are in the correct order. 3. Complete the Excel table "ANCEE Scholarship Applications" to provide the ANCEE with a prioritized list of your applicants. 4. Attach an official letter from the HR Department to "The ANCEE Coordinator" which stipulates the number of applicants and endorses all the applications submitted in this round of selection. Your complete application will consist of: i. Endorsement letter to "The ANCEE Coordinator" ii. Excel table "ANCEE Scholarship Applications" dully completed iii. One .PDF file for each applicant 5. Make sure to send your comlete application to the ANCEE before 4:00 PM (Abidjan local time) on February 1, 2017 to [email protected] Information Mme Adya AFANOU Business Development & Marketing Officer AFRICAN NETWORK OF CENTERS OF EXCELLENCE IN ELECTRICITY (ANCEE) Tel.: +225 22 516 114 / 102 Mob: +225 56 727 155 [email protected] Page 2 ANCEE Scholarship Application Form – Round 3 ALL QUESTIONS ARE MANDATORY 1. IDENTIFICATION OF THE SCHOLARSHIP APPLICANT 1.1 LAST NAME: Click here to add text. 1.2 Given Name(s): Click here to add text. 1.3 Gender: 1.4 Date of birth: (Day / Month / Year) Female Click here to add text. 1.5 Nationality: Click here to add text. 1.6 Tel.: Click here to add text. 1.7 Mob.: Click here to add text. 1.8 Fax: Click here to add text. 1.9 Email: Click here to add text. 1.10 Postal Address: Click here to add text. Male 2. EMPLOYMENT & QUALIFICATIONS 2.1 Employer: Click here to add text. 2.2 Country: Click here to add text. 2.3 Employee No.: Click here to add text. 2.4 Date of assumption of office with the current employer: 2.5 Date of end of contract (if applicable): 2.6 Title on assumption of office: Click here to add text. 2.7 Current title: Click here to add text. 2.8 Current duties and responsibilities (max 100 words): 2.9 Title of current direct supervisor: 2.10 Last educational level completed: Click here to add text. 2.11 Specialization or field of study (of the qualification indicated in question 2.10): Click here to add text. Click here to add text. Click here to add text. Click here to add text. Secondary School Education Basic Education Certificate Examination (1st cycle secondary education) High School Certificate (2nd cycle secondary education) BTS Diploma (High School+2 years) First Degree (High School +3 years) Master (High School + 5 years) Doctorate (High School + 7 years) Other. Specify: Click here to add text. Page 3 ANCEE Scholarship Application Form – Round 3 3. TRAINING PROJECT 3.1 Title of the training project: Click here to add text. 3.2 Area of the training project (please check only one): Power Generation Transmission Distribution 3.3 Field of Expertise of the training project (please check only one): Energetic Efficiency Environmental Assessment Renewable Energy Equipment, Operations & Maintenance of plants Strategic Governance Study & Development Leadership Development Operations Management Personnel & Human Resources Management Planning Pricing Procurement Security Other Commercial, Administrative, Legal or Financial Management Other. Please specify: Click here to add text. 3.4 Objective(s) of the training project: Fill a gap Increase performance Plan for the deployment of a new technology Training of trainers Other. Please specify: Click here to add text. 3.5 Focus subject(s) or content of the desired training course (brief list): 1. Click here to add text. 2. Click here to add text. 3. Click here to add text. 4. Click here to add text. 3.6 Desired skill(s) (brief list): 1. Click here to add text. 2. Click here to add text. 3. Click here to add text. 4. Click here to add text. 3.7 Software or Special Equipment Needed (if applicable): 3.8 Language for the training: Click here to add text. English French Other. Please specify: Click here to add text. Page 4 ANCEE Scholarship Application Form – Round 3 4. SUPPORTING DOCUMENTS * Ensure that you provide all these mandatory documents and that each copy is readable. An incomplete application or one comprising of supporting documents deemed unsatisfactory will be automatically rejected. ** Check the corresponding box for of each document. A) Copy of an ID with your photo (both sides) B) Copy of Certificate considered in question 2.10 I, the undersigned, hereby certify that the information provided in this application for a training scholarship is complete and true. Done in ____________________________ On______________________________ Given Name(s) LAST NAME Click here to add text. Signature: Page 5
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