1. PROGRAM APPLICATION FORM Seoul Human Resource Development Center Metropolis International Institute Headquarter Attach Your Scanned Photo Nambusunhwan-ro 340-gil 58, Seocho-gu, Seoul, 137-071, Korea Phone: 82 2 3488 2059 Fax: 82 2 3488 2346 Web : http://www.facebook.com/shrdcinfo E-mail: shrdcinfo@gmail.com Note: Please complete this form by typing in your answers. Please complete the form in English. Please do not handwrite your answers. If any fields do not apply to you, please write “N/A”. Do not leave any fields blank. Ⅰ. PROGRAM TITLE : Ⅱ. PERSONAL DATA : (First) (Middle) (Last Name) Date of Birth City/LocalityNationalityGenderReligion DayMonthYear M ( ) / F( ) e-mailOffice Phone SNS (Facebook, Twitter, QQ)Mobile Phone Emergency Contact Name : Emergency Contact Number : (country code) (area code) Dietary Requirements : ※ I don’t like/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.

2. Ⅲ. EMPLOYMENT AND EDUCATION (Continued) Describe your present duties: Training experiences in Korea (if any) Yes ( ) No ( ) Name and Period of Program : Organized by : Ⅳ. ENGLISH LANGUAGE PROFICIENCY *Please tick(√) the box accordingly. ExcellentGoodFairPoorRemarks 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 Ⅵ. What module of the program do you expect to be most valuable?

3. APPLICANT'S RESPONSIBILITIES If accepted as a participant, I agree: 1)To follow the training program to the best of my ability and abide by the rules of the SHRDC during the training program; 2) To refrain from engaging in political activities, or any form of employment for profit or gain; 3) To return to my home country upon completion of my training program and to resume work in my country; 4) To accept that the SHRDC is not liable for any damage or loss of my personal property; and 5) To accept 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, however, SHRDC will prioritize safety/accident insurance for each participant. Applicant's Name: Date : Signature:

4. Letter of Recommendation Paul Moon President Seoul Human Resource Development Center Nambusunhwan-ro 340-gil 58 (Seocho-dong 391), Seocho-gu, Seoul 137-071, South Korea Dear, President Paul Moon Upon understanding the goals and objectives of your international training course and hoping to promote our administrative exchanges, I hereby recommend the following person as our city’s participant in your training 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 first name :  Applicant’s last name :  Position : 1. Department: 2. Date of Birth: Date: [Recommender’s Profile] Title: Name: Signature: