APPLICATION FORM

Please submit all materials electronically to gsum@bricspolicycenter.org

Only in case of selection, printed and signed copies of the full application must also be sent via post mail to BPC (BRICS Policy Center/Centro de Estudos e Pesquisas BRICS. Rua Dona Mariana, 63 | Botafogo. Postcode: 22280-020, Rio de Janeiro, RJ. Brasil)

Please attach a picture

FULL NAME:

CITIZENSHIP:

TITLE:

INSTITUTIONAL AFFILIATION:

ADDRESS FOR CORRESPONDENCE:

PASSPORT NUMBER (Please attach a copy of the main pages of your passport):

TELEPHONE:

EMAIL:

SKYPE ID:

Global South Unit for Mediation / BRICS Policy CenterRua Dona Mariana, 63 | Botafogo | Postcode: 22280-020

Rio de Janeiro | RJ | Brasil | Phone/Fax: (55) 21-2535.0447gsum@bricspolicycenter.org | www.bricspolicycenter.org/gsum

Recommenders

Please ask two recommenders to write about your ability to conduct GSUM related research/teaching activities. Recommenders should send letters directly to: gsum@bricspolicycenter.org

Only in case of selection, the original letters must be attached to the full application and sent via post mail to BPC (BRICS Policy Center/Centro de Estudos e Pesquisas BRICS. Rua Dona Mariana, 63 | Botafogo. Postcode: 22280-020, Rio de Janeiro, RJ. Brasil)

1. NAME:TITLE AND INSTITUTION:EMAIL:

2. NAME:TITLE AND INSTITUTION:EMAIL:

Paper Introduction

A brief introduction (1.500 – 2.000 words) related to one or more of the six themes stated in this call for applications. This should be the basis for a Policy Brief and/or and Academic Paper to be published in English at the GSUM website. Fellows coming from Global South countries are encouraged to write about their region´s experience in conflict resolution/international mediation.

Additional Information

The selected Fellows agree with the following copyright rule referent to the academic production while at GSUM:

"All rights reserved according to law. No part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system,

without the prior written consent of the Global South Unit or Mediation.

The opinions and content expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of the institutions to which they are affili-

ated."

Full name: ____________________________________________ Signature: ________________________

* IMPORTANT: Applicants will be notified about whether they have been selected on May 15th 2015. The selected candidates will be interviewed via telephone or Skype before final decisions are made.