Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Last Name (as it appears in the passport) First Name Middle Name Gender Date of Birth (DD/MM/ YYYY) City of Birth Country of Country of Birth Citizenship
1 2 3 4 5 6 7 8 9 10 11
Male
3/9/1981
Cambodia Cambodia Cambodia Cambodia Cambodia Cambodia 5/5/1975 Kampong Cham Province Cambodia Cambodia 6/8/1974 Cambodia Cambodia Cambodia Cambodia Cambodia
Country of U.S. Program Residence Embassy or Dates Consulate (only if (location of differ visa from interview) group dates)
Job Title
Name of Employer
Phnom Penh Phnom Penh Phnom Penh Phnom Penh Phnom Penh Tokyo Phnom Penh
Deputy Head Royal School of Administration Head of Research and International Administration Royal School of Relations Deputy Director of Continuing Program Royal School of Administration Vice Director, Graduate Program of Law and Economics Royal University Coordinator/Deputy Bureau Chief for Civil Service State Secretariat Vice Dean Royal University of Law and Economics
Type of Address of Work Employer Employer Telephone/F (Government, (Building ax Academic, Number, NGO, Etc) Street, City, Mailing Code) Government Government Government Government Government Government
Home Home Personal Email Addresss Telephone/F (Building/ ax Apt. Number, Street, City, Mailing Code) #17, St. 466 Nhiek Tioulong, Phnom Penh, Cambodia 163, Beng Kangkang 3, Chamkar Mon, Phnom Penh C 855.23.99.76.58 N/A No. 460CEo, St. 855.12.77.94.77 bunnarithch@gmail.com #17, St. Nhiek Tioulong 466, Phnom Penh, Cambodia Sangkat Boeung Keng Kang 1, Khan Chamkamorn, Ph 855.23.99.76.58 era.rsa@gmail.com 282, #11, Steet 855.68.67.77.76 nhemvichika.rsa@gmail.com #17, St. Nhiek Tioulong 466, Phnom Penh, Cambodia 855.23.99.76.58 N/A #499, Street 135, Sangkat Phsardermthkov, Khan Chamkarmon, Phno 855.12.51.18.30 phanit.sr@gmail.com #17, St. Nhiek Tioulong 466, Phnom Penh, Cambodia Group 9, Phoum Tuol Sangke, Sangkat Tuol Sangke, 855.23.99.76.58 N/A #004, Street K5, 016.846.622 hphalthy@yahoo.com Downtown Road 7 Corner Street 2004, HouseChambak Village, Sangkat Chomchao,Kak II, Pursenchey, Phnom N/A N/A Kouk 18B, Street 614BIS, Sangkat Boeung Khan Khan Tuol Kork, Ph 855.12.669.735 thonglim_him@yahoo.com
rosa.ifl@gmail.com s_sophorn@hotmail.com
Work Email
Cell/Mobile Phone
@gmail.com
N? N?
N N N N N N N
1 2 3 4 5 6 7 8 9 10 11
Wicaksono Male Aditia Male Marganda Male Dini Anggraini Putri Female Female Female
25/04/1980 Indonesia 22/09/1984 Indonesia 16/09/1982 Palembang Indonesia Indonesia 25/04/1967 Indonesia 12/10/1979 Indonesia 6/12/1976
Country of Residence
U.S. Program Job Title Embassy Dates or (only if Consulate differ (location of from visa group interview) dates)
Program Manager Administrator Staff/Lecturer Chief of Advocacy Division Deputy Chief of Party Executive Director Director, Monitoring, Evaluation and External Relations
Name of Employer
The Partnership for Governance Reform in Indonesia (Kemitraan) Secretariat-General of the People's Consultative Assembly of the Republic of Indonesia National Institute of Public Administration of Republic of Indonesia Pusat Studi Strategi & Kebijakan International Foundation for Electoral Systems (IFES) Association for Election & Democracy (Perludem) Indonesian Center for Law and Policy Studies
Type of Address of Work Employer Employer Telephone/ (Government, (Building Fax Academic, Number, NGO, Etc) Street, City, Mailing Code)
Home Home Personal Address Telephone/Fax Email (Building/A pt. Number, Street, City, Mailing Code) Jl. Wolter Monginsidi No. 3,N/A N/A Jakarta, 12160, Indonesia Barat XVII/No. 11, Cempaka Putih, Jakarta, 10520, Jl. Cempaka Putih 622.142.428.66 setio.soemeri@gmail.com Jl. Gatot Soebroto No. 6, Jakarta 10270, Indonesia 622.174.705.566 b3740k@yahoo.com Indonesia N/A N/A Jl. Putih Melati D6 No. 3, Kelapa Gading, Jakarta 14240, STIA LAN Bandung Jalan Cimandiri No. 34-38Terusan628.122.026.837 dinoroy@aritonang@gmail.com 6222.423.7375 N/A Jalan Bandung, West Java, Sabilulungan No. 39 Muararajeun, Cihaur Ciliwung Gg. Indonesia 40115 Jl. Kelelelawar No. 56, Sidodadi, Kedaton,Rasuna Said gang. Perkutut No. 22, Pengajaran, Teluk Betung Utar 0721.700.957pussbik_lpg@yahoo.co.id856.696.265.00 dayatz.66@gmail.com Jl. Bandar Lampung, Indonesia, 35147 IFES-Intiland Tower, 19th Floor, Jl. Jend. Sudirmanno. 61, Ceger, Jakarta 13820 622.157.956.795 adsalim@ifesindonesia.org Jakarta 10220, Indonesia Jl. Gempol 32, 622.184.590.163 admira_dini@yahoo.com Gedung Dana N/A Lantai 1 Ruang 108 Jl. GondangGg. Bakti No. 22 Jakarta Pusat, DKI, Jakarta, Indonesia Graha Jl. Aria Putra 622.174.705566 RT. 06/15 Kedaung, Pamulang, Tangera Kecil No. 12-14 ti.anggraini@gmail.com Puri Imperium Office Plaza UG Floor Unit Kebon Sirih no. 75, Jakarta Kav 5-6, 12980, Jakarta Selatan Indone 62.21.8370.1809 Jl. 11-12, Jl. Kuningan Madya Pusat 10340 DKI Jakarta 62.21.788.44249 gepede76@gmail.com
Work Email
Cell/Mobile Phone
62818697850 Y 815.808.0776
dinoroy@aritonang@gmail.com dayatz.66@gmail.com
N N Y N N N N
1 2 3 4 5 6 7 8 9 10 11
Myadagmaa
Tsedendamba
Female
24/07/1980
Mongolia
Country of Citizenship
Country of U.S. Program Job Title Residence Embassy or Dates Consulate (only if (location of differ visa from interview) group dates)
Name of Employer
Type of Address of Employer Employer (Government, (Building Academic, Number, NGO, Etc) Street, City, Mailing Code)
Mongolia
Ulaanbaatar
Head of AdministrationGovernment Implementing Agency-Foreign Inve Mongolian Division Government Sambuu Street-11, Governm
Work Telephone/F ax
Work Email
Home Home Personal Addresss Telephone/F Email (Building/ ax Apt. Number, Street, City, Mailing Code)
Cell/Mobile Phone
976.11.320.793 yadagmaa@investmongolia.com 5thmyadagmats@yahoo.com m #c-21, Golomt Building, 976.990.96.774Khoroo, Sukhbaatar District, Ulaanbataar, Mongolia 976.990.967.74
1 2 3 4 5 6 7 8 9 10 11 12
Jung-Ping Huang Liu Yen Teng Chuang DGPA 1 DGPA 2 DGPA 3 DGPA 4 DGPA 6 DGPA 6
Country of Residence
U.S. Program Embassy Dates or (only if Consulate differ (location of from visa group interview) dates)
Job Title
Name of Employer
Assistant Editor Sub-Chief Senior Staff Graduate Student Policy Analyst Civil Service Ethics Director
National Sun Yat-sen University Academic Bureau of Education, Kaohsiung City Government Government Department of Government Ethics, National Security Bu Government Tunghai University, Department of Political Science Academic Citizen Congress Watch NGO Tinan City Mayor Government
Home Home Personal Cell/Mobile Addresss Telephone/F Email Phone (Building/ ax Apt. Number, Street, City, Mailing Code) No. 70, LienhaiN/A Kaohsiung, Taiwan 80424 Rd, phillip.sun@msa.hinet.net 7F-1, No. 33, Ming-Zhe Rd, Sanmin District, Kaohsiung City 807, Taiw 1 886.07.345.6898 sunjungping@gmail.com 886.0912.120.125 No. 192, Zhongzheng 4th Rd., Qianjin Distr., Kaohsiung City 801, Taiwan (R.O.C.) 886.7201173 joy118@kcg.gov.tw No. 116-1Yiyong Rd. Lingyahyc0118@gmail.com 802, Taiwan (R.O.C. 886.933.591.536 Dist., Kaohsiung City No. 110, Sec. 1, Yangde Blvd, Shilin Dist., Taipei City 111, 19F.-1, No. 263, Sec. 2, Datong Rd., Xizhi District, New Taipei City 221 001.886.228.359.070 Taiwan (R.O.C.) 001.886.286.917.234 jeffhonliu@gmail.com 011.886.920.064.015 N/A N/A G10053202@thu.edu.tw No. 1, Ln. 280, Zhongxing St., Beidou Township, Changhua County 52 886.488.83643 branda.juyu.yen@gmail.com 886.932.036.624 22F, Minsheng Rd, Chaozhou Township, Pingtung County 920, Taiwa 855.12.99.47.06 yuanivan1121@gmail.com 886.91.17.28.666 886.89.322.003 l21641.liu@msa.hinet.net hbethics@mail.tainan.gov.tw
Address of Work Employer Telephone/Fax (Building Number, Street, City, Mailing Code)
Work Email
.tainan.gov.tw
N N N N N N