DinasPemuda dan Olahraga Jawa Barat

Bidang Pengembangan Kreativitas Pemuda

Jl. Pacuan Kuda No.140 Bandung 40293

PurnaCarakaMuda Indonesia
Jawa Barat
info@pcmijabar.org
http://pcmijabar.org

PLEASE FILL IN THIS APPLICATION FORM USING A COMPUTER HANDWRITING IS UNACCEPTABLE

WRITE NUMBERS 1, 2, 3 AND 4 TO RANK YOUR PRIORITY

2 Indonesia-Canada Youth Exchange Program (18-23 years old)

Indonesia-Malaysia Youth Exchange Program (23-27 years old)

1 Indonesia-Korea Youth Exchange Program(18-24 years old)

4 ASEAN Students Visit India (college students, 1924 years old)

3 The Ship for Southeast Asian& Japanese Youth Program (20-30 years old)

If there is a chance, I am willing to join any programme beyond the abovementioned. (YES)

1. PERSONAL DATA
Full Name : SYLVIA LESTARI

JL. SITI ARMILAH NO. 16 RT 03 RW 04 MAJALENGKA KULON, MAJALENGKA

Address :

Place, Date of Birth : CIANJUR, 05 FEBRUARI 1994

Sex : PEREMPUAN

Home Phone Number : (0233) 281963

Mobile Phone Number : 082137813102

E-mail : sylvialestari940@gmail.com
Interests / hobbies : singing, travelling, listening to music

2. EDUCATIONAL BACKGROUND(State your GPA if applicable)

Year (from-to) Institution
Elementary School SDN MAJALENGKA KULON 1

Junior High School SMPN 3 MAJALENGKA

Senior High School SMAN 1 MAJALENGKA

this form is downloadable at http://pcmijabar.org

 University UNIVERSITAS ISLAM SULTAN AGUNG SEMARANG

3. ACHIEVEMENTS and AWARDS (top five)

Date awarded Remarks
Runner Up English Speech Contest, Majalengka 1 Senior High Public School
2009
2nd Winner KPOP Singing Contest, Sultan Agung Islamic University
5 June 2012

14 November 2016 TOP 9 Hangeul Competition Finalist

4. ORGANISATIONAL EXPERIENCE(top five, including seminars, workshops, camps, trainings, etc.)

Date attended Remarks
30 September-20 October Elective Program with Pediatrics Department (Allergy and Pulmonology) at Yonsei University College of
2015 Medicine, Korea

16 October 2015 Congress Symposium : Understanding the Matters of Asthma Control in the Real World, Seoul Korea

International symposium of humans health and aging sciences (ISHHAS)

27-28 January 2017

5 May 2016 Seminar : Medical Updates on Maternal Health Care

17 March 2012 Seminar : Acute Coronary Syndrome

5. SOCIAL/ENTREPRENEURSHIP ACTIVITIES (mention top 5 activities, IF Any)

Activities Institution Year Location
CIMSA (Center for Sultan Agung Islamic Hospital
Indonesian Medical
Volunteering in HIV AIDS Day Students' Activities) 2014
UNISSULA Semarang,
Indonesia

CIMSA (Center for Sultang Agung Islamic Hospital

Indonesian Medical
Volunteering in Diabetic Day Students' Activities) 2014
UNISSULA Semarang,
Indonesia

CIMSA (Center for Desa Tambakmulyo, Semarang

Indonesian Medical
Volunteering in Public Treatment Students' Activities) 2013
UNISSULA Semarang,
Indonesia

Faculty of Medicine of Desa Batur, Salatiga

Volunteering in Public Treatment UNISSULA Semarang, 2012
Indonesia
Volunteering in English day CIMSA (Center for 2013 SDN Kembangsari 01 Semarang

this form is downloadable at http://pcmijabar.org

 Indonesian Medical
Students' Activities)
UNISSULA Semarang,
Indonesia

6. FOREIGN-LANGUAGE SKILLS
Language Spoken Written Language Competencies Score (if any)
poor poor TOEFL-ITP : 473
English fair fair IELTS :
excellent excellent TOEIC :
poor poor
Korean fair fair
excellent excellent
poor poor
Other (please specify) fair fair
excellent excellent

DECLARATIONOF AUTHORISATION
I hereby certify that the statements above are true, complete, and correct to the best of my knowledge and belief. Permission is given to the
selection committee to make such investigations if necessary on the aforesaid information. I understand that any misrepresentation or material
omission made herein or in any other documents may lead but not limited to termination or dismissal of the program.

Full name : SYLVIA LESTARI

Date of application : 29 Maret 2017

this form is downloadable at http://pcmijabar.org

1. Mention 3 words that best describe your reasons to join the International Youth Exchange
Programmes (PPAN). How do you define those words in relation to your life purpose? (Max. 250
words)

I AM INDONESIAN
I have been waiting for so long to join this International Youth Exchange
Program. The program will lead us to introduce our beloved Indonesia to around
the world. Also, we can share with friends from another country about our culture.
We can make a many friends. The most important thing is we can realize how
lucky we are as Indonesian, because Indonesia is rich of beautiful culture.

2. Tell us about your experience when entering a new environment that you found unfamiliar. What did
you do to adjust yourself? (Max. 250 words)

West Java to Central Java

I was born in Cianjur but I had been living in Majalengka since 23 years ago.
When I had graduated from Senior High School, I went to Sultan Agung Islamic
University, Semarang. It means I moved to Central Java. Ive been living in Semarang
for 5 years. We know that West Java had Sundanese language and Central Java had
Javanese language. In Javanese dahar means eat. It is a polite word which use for
older but in Sundanese it is not polite word which use for the same age. Sometimes I
found a same word but has different meanings, example gedang means papaya but
in Javaness gedang means banana. I learned many things in Semarang which is
really different with Majalengka. It was interesting with those difference and made me
want to learn more abot the culture of Central Java. I realize that Indonesia had a
many culture in every city, province, and island. It makes me as Indonesian have to
study more about Indonesia.

3. Tell us about your experience in making a change at your organization/social. What are the impacts of
that change? Explain one of your experiences in making a significant change in your organisation or
your environment. How did you create the change and what was the impact? (Max. 250 words)

Herbal Handsanitizer from Aloe vera

On November 2016, when I was in Public Health Department, I tasked by my
teacher to make a problem solving in one village of Semarang. I and my group were
survey for the health problem in that village. High of morbidity of diarrhea is the main
problem of that village. We saw that people there have washing hand habbit rarely.
We thought that bad habbit of washing hand cause diarrhea. Then, we saw people in
the village have aloe vera in front of their home. We saw the potential and we thought
to make kind of handsanitizer. Finally, we made a herbal handsanitizer from aloe vera.
So, people can washing hand easier. The handsanitizer was easy to make, easy to
use, and cheaper than the other handsanitizer. With herbal handsanitizer, we hope
people of the village will wash their hand before eat. So, the morbidity of diarrhea will
be decrease.

this form is downloadable at http://pcmijabar.org

4. PCMI is an alumni association of the international youth exchange programmes (PPAN). In your
opinion, what potentials can be further developed from this association? Upon the completion of your
participation, what would you contribute to this association? (Max. 250 words)

International Youth Exchange Program

Firstly, I found International Youth Exchange program from social media. I
found that the programme will share about culture of many countries. It is interesting
because I want to know the other culture from other country and I love to learn new
things. I love to make a new friends from other country. I love to introduce Indonesian
culture to the other country and I want they know how beautiful Indonesia. From this
programme, we can learn about Indonesia even more because we know that Indonesia
have so many islands, native languages, foods, and unique cultures. This programme
can make us more proud to be Indonesian.

5. Mention one West Javanese figure (either a fictional character or a real person) who best represents
your leadership character. Explain the reasons. (Max. 250 words)

Ridwan Kamil
Mr. Ridwan Kamil is my favorite figure from West Java. He is not only good-
looking but also smart and spirited to make Bandung better. He did many innovation
for Bandung. He always has a uniqe solution for every problem that he found. It made
Bandung people want to do a good thing too for Bandung. Now we can see that
Bandung had many good changes. I admire Ridwan Kamil as Mayor of Bandung city.
He can affect the people to make a beautiful Bandung together. I learned many things
from him. I learnned how to be a smart leader but still care, loyal and fun.

this form is downloadable at http://pcmijabar.org

this form is downloadable at http://pcmijabar.org
this form is downloadable at http://pcmijabar.org
this form is downloadable at http://pcmijabar.org
this form is downloadable at http://pcmijabar.org
this form is downloadable at http://pcmijabar.org
this form is downloadable at http://pcmijabar.org
this form is downloadable at http://pcmijabar.org
this form is downloadable at http://pcmijabar.org
this form is downloadable at http://pcmijabar.org