Todd Sui (China, ppt 3)

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	Todd Sui (Sui Xin in Chinese)
2. Date of Birth (DD/MM/YYYY)	26/05/1978
3. Country	The People’s Republic of China
4. (Organisation affiliated to) optional	Beautiful Life Health Promotion Center in Shanghai
5. Current occupation	Programme officer
6. Number of years working on MSM or TG activities	2.5 years
7. Phone and Email address	Phone:+8615821770338
	Email:yumolesa@gmail.com
8. Highest educational level attained
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.

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 Experience

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

I have worked for the Beautiful Life as a Programme Officer since 2008. I contribute to the MSM and PLHIV community with my strength and knowledge. My major experiences are as below:

1) MSM+ community building and volunteer capacity building of Global Fund Round 6;

2) Organizing PLHIVs badminton club and English corner every weekend;

3) Beautiful Life A&K Salon supported by GF RCC;

4) Counselling and care support for more than 240 PLHIV who newly diagnosis of HIV positive;

5) Conducted more than 20 times basic knowledge training for PLHIVs and more than 25 times peer outreach at AIDS Treatment and Care Hospital.

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 am a Chinese MSM who live with HIV since 2007. I know it is critical for PLHIV to get counselling and support from peers and community from my personal experience. I got to know more about the situation and right concepts about HIV and AIDS. I have some strength to contribute to the programme:

Ÿ Full-time job: over 9 years career experience with 5 years intensive delivery of PM across domestic and overseas areas. I believe it helps me a lot in HIV and MSM programs.

Ÿ Advanced level of English communication, both verbal and written

Ÿ Well-organized and strong execution ability within framework and policies

Ÿ Enjoy tasks that require quick-thinking and problem solving, enjoy working under high pressure and multi-tasking

Ÿ Motivated achiever who exceeds goals and enjoys new challenges and green field projects

Ÿ Also a quick learner and would like to share experience with peer and colleagues.

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

I will devote myself to the work in HIV/AIDS and would like help more PLHIVs in Shanghai to step out shadow and lead a normal life. We will co-work with my colleagues to spread correct concepts and curing knowledge about HIV and AIDS to the community. I plan to promote the cooperation between NGOs and related government departments in Shanghai, even the national level. I also plan to extend the working field to MSM. How to advocate the negative homosexuality community with healthy life and safe sex behaviour is also what I am interested in.

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	HE Jinglin
Position	Senior Programme Officer-
Organisation	WHO, China
Phone (including dialling code)	+8613811525634
Email	heji@wpro.who.int
How did you know this person	Jinglin is one of the supporters for the Beautiful Life since it was established

Name	ZHOU Yi
Position	Director
Organisation	Beautiful Life Health Promotion Center in Shanghai
Phone (including dialling code)	+8615921689393
Email	"Joe Zhou"
How did you know this person	Todd is one of Zhou Yi’s colleagues

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