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 31st December 2010.
1 - Personal Information
| 1. Full name of Applicant | Xiao Jian |
| 2. Date of Birth (DD/MM/YYYY) | 13/02/1978 |
| 3. Country | China |
| 4. (Organisation affiliated to) optional | Shanghai Homeland of Care and Love Group |
| 5. Current occupation | Software manager |
| 6. Number of years working on MSM or TG activities | 3 |
| 7. Phone and Email address | Phone:13818716636 |
| Email:997935194@qq.com | |
| 8. Highest educational level attained | Double bachelor’s degree |
| 9. Current English language proficiency | Reading
Writing Basic Intermediate Advanced
Comprehension Basic Intermediate Advanced
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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?
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
I’m so glad to have this opportunity to introduce my working experiences and skills which gained from my daily works since I built this community.
Since I’ve been the leadship of the local NGO—Shanghai Homeland of Care and Love Group which focus on MSM+ individuals for 3 years,I’ve leaned lots of skills and experiences as a HIV+ individual in general MSM and HIV activities.our Group is dealing with AIDS prevention and HIV+ individuals,we hold activities to help the HIV+ individuals and to coordinate the relations between the individuals and our Group,
Manys MSM peole have no sence of the dangers of HIV,so there is much unprotectable sex in their daily life.Someday they may regret this ,especially when they were diagnosed as HIV+.TO avoid this situation,we do our best to comfort them,and help them go through the most toughest period.For HIV prevention work ,we regularly go to gay bars ,bathhouses and parks where MSM people gathered,to pass out condoms and booklets and hold activities to tell MSM facts about AIDS
We have held many successful activities and other kinds of AIDS prevention activities.During these events we invite experts to share their knowledge about HIV.Many friends ask lots of questions ,and discuss the problems they may face in their daily life.we also have some questions to ask the HIV+ friends ,and when they answer correctly ,we give them some presents.This creats an active and friendly atmosphere to help the HIV+ individuals
We have applied for funds and make budget for the best use of this financial assistance,we also have contacted and learned from other local NGOS. All in all ,we need to use many social forces to build a community with no discrimination against HIV+ people.
I’d like to contribute all my lifetime to help all the MSM group and HIV+ PEOPLE.
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
FIRST,I’d like to say that I’m so honored to apply for this program.AS a leadship of our Group for 3 years,I’ve accumulated lots of experiences to handle problems.As a leadship.i am familiar with the NGO works,and I have hold lots of activities successfully to promote the relations between our group and HIV+ individuals. Our group covers nearly 200 HIV+ individuals,and lots of people have got mental benefits from our activities,
Secondly,I am also in charge of East China Region PLHIV Cooperation Network(ECPN), as a leadship of ECPN,our responsibility covers lots of aspects.i have to coordinate the relations between 1 city and 6 provinces.And sometimes,we can transfer patients for the treatment conveniences.Now and then ,we always hold meetings to discuss the methods to help the HIV+ individuals.
On the national level,I also am the member of CCM AIDS Working Group (AWG),I participate the meetings which hold in Beijing frequently to discuss the national issues.so I know the national HIV features which could help me to promote my work as a leadship of ECPN.
One more thing is that I am a manager of a software company,I can handle my time freely for going abroad if I were a successful candidate.i also can transfer my company working experience in how to run a company and manage staffs to my HIV group jobs
The last reason why I am suitable for the programe is also the most important reason.i am so eager for creating a good atmosphere for the HIV+ individuals to live happily.and I am also interested in learning English,I am confidence about my English and my lovely group works.
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
Firstly,I would be so honored if I were a successful candidate,and thanks for giving me this precious opportunity.
If I were a candidate,I would use what I have learned from you to help promoting my group firstly.As 3 years passed by, although my group is becoming maturer,but we lack of international information.we can cooperate with the government organization,and seeking for the publicity from the medias to let the society pay more attention to the HIV+ individuals.And continue to disseminate the AIDS information in the colleges and gay bars to let them know some knowledge about HIV andAIDS.As our most important mission is to prevent more and more peope from suffering HIV+ and AIDS,we have to grab the chance of 1st dec –World Aids Day to disseminate the HIV+ and AIDS information to help the public and MSM groups to avoid HIV+ and AIDS.
It is also good and necessary for our ECPN network ,when I gained the skills and experiences,I can hold a meeting to discuss what I learned from your program,then the leadships from other groups can use what they got to promote their groups.
In the national level,I can tell them what I learned from your program for them to consider the international situation.
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 | Meng Lin |
| Position | Bei Jing |
| Organisation | CAP+ |
| Phone (including dialling code) | 13381151547 |
| | menglin2801@gmail.com |
| How did you know this person | He is famous in our entire country,nearly every HIV+ individuals know him |
| Name | Wu Ya |
| Position | Manager of my group |
| Organisation | Shang Hai Homeland of Care and Love |
| Phone (including dialling code) | 13020267333 |
| | aaway@163.com |
| How did you know this person | He is famours for being working on HIV+ individuals for many years and he is a very good person |
6 - Signature of applicant
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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.
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| Sign |
| Date |
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Xiao Jian |
| 31/12/2010 |
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one vote on behalf of Vijay
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