Qiu Feng (China, ppt 8)

Use this form to complete Positive MSM Community Leadership application – please type or print neatly. This form should be completed in English.

The form MUST be signed and scanned and sent as an email to "Nid" thanid@apnplus.org before CBO (5:00 PM Thailand) on 31^st December 2010.

1 - Personal Information

1. Full name of Applicant	Qiufeng
2. Date of Birth (DD/MM/YYYY)	18/12/1975
3. Country	China
4. (Organisation affiliated to) optional	Internation HIV/AIDS Alliance
5. Current occupation	HIV programme officer
6. Number of years working on MSM or TG activities	5 Years
7. Phone and Email address	Phone:(86) 13808756910
	Email: qiufeng@alliancechina.org
8. Highest educational level attained	University Degree
9. Current English language proficiency	Reading Basic *Intermediate Advanced Writing Basic *Intermediate Advanced Comprehension Basic *Intermediate Advanced

Please check the following boxes below as it pertains to you.

a) Do you have a valid passport or willing to acquire a passport at your own expense?

*Yes No

*Please include a copy of the page that has your information and photo on it i.e. expiry date and passport number.

G18486695

b) Do you need a visa to travel to Bangkok, Thailand where most of the trainings will be held?

Yes No

2 – Personal Skills and Experiences

Please use this space to detail your skills and experiences in general MSM and HIV intervention activities. For example coordination, peer outreach, edutainment activities and counselling etc.

Maximum of-700 words. DO NOT exceed the space provided

More than 5 years HIV/AIDS programme experience, Have the following skills:

Coordination; Peer outreach, Counseling, Technical support, Project management, Volunteer management, Team building, Community mobilization, Advocacy and coordination between the government and so on.

1. Colorful Sky MSM CBO leader (2005-2006)

To be the leader of the local MSM group from 2005 to 2006,During this period, I was responsible for outreach management and volunteer management. Through this process, I start to work close with MSM community people on outreach,(Include park, saunas, public toilet, Online outreach) to improve outreach skills , Better understanding of the local community needs and respond to the health challenges.

Through participating in volunteer recruitment, training, incentive process, and develop our group’ management system.

2. International HIV/AIDS Alliance(2007-2010)

To be a programme officer in AIDS Alliance from 2007 to 2010, I had worked with MSM project , Include community mobilization, Programme management; Coordinate with local government , Develop and support the local MSM network. Because I came from the community, and have more experience on MSM community . So my role in Alliance is focus on supporting the local MSM groups understanding and capacity on HIV.

3. Yunnan MSM technical Working group(2010-2011)

To be a coordinator of the MSM TWG, I had focus on the local MSM network capacity building and advocacy. Coordinate with local government on how to support the local MSM groups.

3 – Personal Statement

Please use this space to detail why you think you are suitable for the programme. Maximum of 700 words. DO NOT exceed the space provided

I want to apply this programme because of :

1. Yes, I have some experience on working with MSM, But for our community development, I faced more challenges, Just like how to develop our community ownership, How to reduce the stigma and discrimination, How to combine our community to respond the rights and advocacy. So I want to keep my step moving.

2. Because this programme will focus on different countries in GMS, So I want to learn each other and can contribute my experience and sharing with others.

3. Although my years old just 35 age , but I work on the MSM and AIDS ‘ belief will not

grow old, I hope that I can use my own experience to share with more people, so that

more people can benefit from it, that is reason what I want to apply this programme.

4 – Future plan after finishing programme

Please use this space to detail how you would apply the learning and skills gained from the program if you were a successful candidate. Maximum of 700 words. DO NOT exceed the space provided

1. Learn and analyse the key point from this programme.

2. Discuss within our local MSM network and Localise the key point from it.

3. Prepare the sharing process with local MSM network.

4. Develop the action plan based on local context on how to use the learning from this programme .

5. Training more community leaders on this programme.

If possible, I will apply the similar project to continue this kind of programme in China.

5 – References

Please list two reference persons (i.e. your past or current employer or focal person of PLHIV national network) we may contact regarding the application.

Name	Menglin
Position	Leader of CAP+
Organisation	Ark of Love
Phone (including dialling code)	(86)10-63297977
Email	menglin2801@gmail.com
How did you know this person	Working relationship

Name	Wanghong
Position	Senior programme officer
Organisation	International HIV/AIDS Alliance
Phone (including dialling code)	(86)871-3610930
Email	wanghong@alliancechina.org
How did you know this person	colleague

6 - Signature of applicant

	Please note that the intention of the APN+ MSM Community Leadership Program is to target those young MSM who are HIV positive within the APN+ affiliated country national networks from the GMR (this includes the whole of China, it is NOT limited to Guangxi and Yunnan provinces only). I hereby certify that the information provided in this application is true and correct. I understand that providing false or misleading information will disqualify me from appointment, or if appointed, will render me liable to dismissal from the program.
	Sign		Date
	Qiufeng		31st Dec,2010