CPS-INTERNATIONAL PEACE AMBASSADOR OF THE YEAR 2018 CENTRE FOR PEACE STUDIES, SRI LANKA

CPS-INTERNATIONAL PEACE AMBASSADOR OF THE YEAR 2018 CENTRE FOR PEACE STUDIES, SRI LANKA APP No: NOMINATION FORM Date Received: Category:.. Name of the candidate:.. Address:.;..... Contact No: Mobile:... E mail:... No: 08, Ali Vanniyar Road, Sammanthurai. Sri Lanka 067-5681818/5681819/0774056741 www.peaceambassador.net peaceambassador2017@gmail.com Page 1 of 13

CPS-INTERNATIONAL PEACE AMBASSADOR OF THE YEAR 2018 CENTRE FOR PEACE STUDIES, SRI LANKA Background of the project The Peace Ambassadors project has been a flagship project of the Centre for Peace Studies (CPS) Si Lanka. As such, it was first defined by the CPS. It was carried out to promote and support the role of people in peace building activities that contribute to living together in dignity and dialogue. CPS firmly believes that Peacebuilding in the world is not an easy target to achieve through the agreements or negotiation without the contribution of the people. It s the prime duty of each and every individual. The Peace Ambassadors are people from across the World, active in civil society organizations and projects. Participants have been chosen due to their motivation to build a better world where a different peace is possible. During the project, they learn about peace and human rights, they develop local projects for peace, and they advocate for human rights and dignity. Participants are also committed multipliers involved in an organization or network, institution and/or informal group. They thus act as ambassadors for the values of human rights, peace, and intercultural dialogue, and they will also bring these values to youth work and to youth initiatives in their communities. The conflict situations addressed by the participants are those where communities are experiencing or recovering from armed conflict, frozen conflicts, racism and aggressive nationalism and hate speech. Discrimination and human rights violations experienced by communities or young migrants and internally displaced people are also covered by the project. Objectives of the project The main objectives of this project are: To promote the presence and the role of every human as positive actors of change in peace-building processes; To strengthen the role of the people in identifying and speaking up against human rights violations, including discrimination, hate speech and those human rights violations; To support the field presence and activities of the Country of Sri Lanka by fostering cooperation with key stakeholders, partners, non-governmental organizations working in the field of peace-building in order to promote the values of the United Nations; To develop the impact and the expertise of the UN s sector in conflict affected areas through non-formal education activities with young people; To develop the competences of 100 peace ambassadors every year in human rights promotion and protection, conflict transformation, peace-building, reconciliation and intercultural dialogue, as well as other specific competences according to the participants needs, related to their role as future ambassadors; To support and give visibility to at least 50 local youth-led projects for peace-building in conflict-affected areas and communities; Page 2 of 13

To enhance the youth ambassadors capacity to take action at a local level in environments affected by previous or ongoing conflicts; To advance youth policy s role in peace-building and conflict transformation; To create and support an International network of youth peace ambassadors to secure the sustainability and medium-term impact of the project. Guidelines for the Designation of Ambassadors of Peace and Goodwill Peace Ambassadors 1. The Centre for Peace Studies (CPS), Sri Lanka has a tradition of enlisting the volunteer services and support of prominent individuals usually from the world of art, academia, literature, sports and entertainment to raise awareness of the aims, objectives and priorities of the Organization, to convey messages about its activities and to extend its public outreach. 2. Due care must be exercised in making such designations and in managing the resulting relationships. To ensure consistency and the maintenance of a high standard in the selection, designation and involvement of prominent individuals in the work of making peace among communities, the CPS has approved the following guidelines. Definition and Selection Criteria 3. The CPS has invited a number of high profile individuals to serve as Ambassadors of Peace as well as specialized Agencies (hereinafter referred to as Agencies ) may designate Goodwill Peace Ambassadors. 4. Individuals invited to serve as Ambassadors of Peace or Goodwill Peace Ambassadors shall: (a) Possess widely recognized talent and accomplishments in the Democracy, Peacebuilding, Education, Women development, Media, Religious Harmony, Child development, arts, sciences, literature, sport or other fields of public life: (b) Be persons of integrity who demonstrate a strong desire to help mobilize public interest in, and support for, the purposes and principles of the Centre for Peace Studies, and who demonstrate the commitment and proven potential to reach out to significant audiences, including decision makers; (c) Possess the personality and dignity required for such high level representative capacity; (d) Normally be influential beyond their national borders, thus having the ability to promote the values of the Centre for Peace Studies, Sri Lanka nationally and internationally; (e) Be knowledgeable about Centre for Peace Studies, Sri Lanka goals and activities and be able to articulate them. Page 3 of 13

Selection and Designation 5. Only Heads of CPS and Partnerships may designate Goodwill Ambassadors. They are expected to inform the Founder of their intention to designate an individual as Goodwill Ambassador before any commitment is made, not less than four weeks prior to the announcement of the designation. 6. Upon notification to the Founder of the intention to designate a Goodwill Ambassador, an explanation of the reasoning behind the designation will be provided, along with proposed terms of reference and confirmation that the appropriate due diligence to determine suitability has been conducted. 7. The under-founder for Communications and Public Information shall advise the Founder and will endorse the appointment on behalf of the founder, at which point a commitment and public announcement can be made. A period of four weeks will be allowed for the Founder to respond and to endorse the new Goodwill Ambassador appointment. 8. The Directors of Centre for Peace Studies, Sri Lanka, Information Centres and other field offices shall not designate Goodwill Peace Ambassadors. 9. Ambassadors of Peace and Goodwill Peace Ambassadors are not considered Centre for Peace Studies, Sri Lanka staff members and may not be appointed to an established Centre for Peace Studies, Sri Lanka post or office. Therefore, they shall not be granted a Centre for Peace Studies, Sri Lanka Letter of Appointment. 10. Ambassadors of Peace shall be granted a Letter of Designation issued by the Secretary-General. Goodwill Peace Ambassadors shall be granted a Letter of Designation issued by the Heads of the relevant CPS Head office. 11. The Letter of Designation shall set out their terms of reference and length of designation. 12. Designation of a Goodwill Ambassador is to be considered rare and exceptional. The designating CPS Head office should ensure that the number of Goodwill Peace Ambassadors is kept to a minimum, in order to maintain the value attached to the designation. The Founder strongly recommends that each CPS entity regularly evaluate their Goodwill Peace Ambassadors program with a view to keeping it functional, prestigious and unique. 13. An individual shall not be designated Goodwill Peace Ambassador by more than one at the same time. 14. In the interest of courtesy and transparency, requests for the participation of Ambassadors of Peace and Goodwill Peace Ambassadors in Centre for Peace Studies, Sri Lanka activities shall be made through the designating CPS Agency. Role of Ambassadors of Peace and Goodwill Peace Ambassadors 15. The role of Ambassadors of Peace and Goodwill Peace Ambassadors is to engage in public advocacy; in fundraising where authorized and in accordance with the applicable regulations, rules, policies and procedures of the designating CPS Agency, and in public awareness activities. They are encouraged to participate in Centre for Peace Studies, Sri Lanka events and to visit Centre for Peace Studies, Sri Lanka operations in the field. 16. Every Ambassador of Peace and Goodwill Ambassador is expected to participate or conduct public awareness or benefit programs in a minimum of three activities or events every year. 17. The Ambassadors of Peace and Goodwill Peace Ambassadors are encouraged to develop an area of special focus, which would strengthen their advocacy role. This Page 4 of 13

would provide the possibility of making them a 'go-to' person, who can speak authoritatively on a particular issue. 18. The Ambassadors of Peace and Goodwill Peace Ambassadors are encouraged to develop volunteerism in the country through community or village level activities. 19. The Ambassadors of Peace and Goodwill Peace Ambassadors are encouraged to recommend / nominate maximum of ten (10) active members from the community every year to this prestigious award of Ambassadors of Peace and Goodwill Peace Ambassadors 20. The Founder or the designating CPS Agency is responsible for establishing specific terms of reference for individual Ambassadors of Peace or Goodwill Ambassadors. In general, all Ambassadors of Peace and Goodwill Peace Ambassadors are expected to: (a)respect the Constitution of the Democratic Socialist Republic of Sri Lanka and the law, and that I will be faithful to the Republic of Sri Lanka and uphold and defend the Constitution of the Democratic Socialist Republic of Sri Lanka. (b)respect the impartiality and independence of the Centre for Peace Studies, Sri Lanka and to refrain from any conduct that would adversely reflect on the Government of Sri Lanka and the Centre for Peace Studies; (c) Refrain from any activity incompatible with the purposes and principles of the Government of Sri Lanka and the Centre for Peace Studies; (d)exercise good judgment and discretion in all matters relating to the performance of their functions for the Government of Sri Lanka and the Centre for Peace Studies; (e)obtain guidance on their specific activities from the Head of the relevant CPS Agency, or staff assigned to liaise with them. Conditions of Service 21. Ambassadors of Peace and Goodwill Peace Ambassadors shall be designated for a period of two years, renewable, based on mutual agreement by the parties on the basis of satisfactory fulfillment of the role and their demonstrated interest in continuing the relationship. In order to diversify the program, all appointments should be of limited duration and comprise no more than three consecutive mandates. In exceptional cases based on a review and outstanding performance, the appointment of a Goodwill Ambassador or Ambassador of Peace can be extended further. 22. Ambassadors of Peace and Goodwill Peace Ambassadors shall not be paid a salary, although a symbolic payment of $1 per year or equivalent may be granted to them. They may be given travel and daily subsistence allowances when they are traveling on behalf of the Centre for Peace Studies. 23. When on official travel or performing services for the Centre for Peace Studies, Ambassadors of Peace and Goodwill Peace Ambassadors are considered as having the status of Expert on Mission for the Centre for Peace Studies, Sri Lanka. 24. As Experts on Mission, Ambassadors of Peace and Goodwill Peace Ambassadors shall not normally be entitled to a Centre for Peace Studies, Sri Lanka laissez-passer. Page 5 of 13

25. When traveling on behalf of the Centre for Peace Studies, a Ambassador of Peace or Goodwill Ambassador shall be entitled to the standard of travel normally accorded to senior Secretariat officials (ASG and above). Agencies should encourage selffinancing by Ambassadors of Peace and Goodwill Peace Ambassadors of all travel related expenses whenever possible. 26. Ambassadors of Peace and Goodwill Peace Ambassadors who are authorized to travel at Centre for Peace Studies, Sri Lanka expense or who are requested to perform services on behalf of the Centre for Peace Studies, Sri Lanka shall, in the event of injury, illness or death attributable to the performance of duties on behalf of the Centre for Peace Studies, not be entitled to compensation. 27. Ambassadors of Peace and Goodwill Peace Ambassadors shall be fully responsible for arranging, at their own expense, such life, health and other forms of insurance covering the period of their services on behalf of the Centre for Peace Studies, Sri Lanka as they consider appropriate. They are not eligible to participate in the life or health insurance schemes available to Centre for Peace Studies, Sri Lanka staff members. Communication and Information 28. The designating CPS Agencies and Partnerships shall ensure that the special skills and talents of all designees are well utilized for the benefit of the Organization, and that they are provided with regular and appropriate guidance on their activities on behalf of the Centre for Peace Studies. The designating CPS entities shall ensure internal programming, funds and staff (Coordinator) dedicated to support the work with Ambassadors of Peace and Goodwill Ambassadors. This officer will be the primary liaison person for the MOP/GWPA. The designating CPS Agencies, Offices, Funds and Programs shall also consult the CPS Department of Public Information on activities involving Goodwill Ambassadors, as appropriate. 29. Messages should be consistent across the CPS family and all organizations are encouraged to collaborate and facilitate messaging with other Agencies, FCPSds, Programs and Partnerships in the spirit of one CPS. 30. Each designating CPS Agency and Partnerships shall maintain an updated list of its Goodwill Peace Ambassadors and other high-profile celebrities supporting the Centre for Peace Studies, and place it prominently on their website. They shall ensure that all changes in the status of their designees are communicated in a timely way to the under-founder for Communications and Public Information, and are reflected in the relevant public information materials in a timely manner. 31. The CPS Department of Public Information (DPI) shall be the focal point for consultation and communication on policy issues relating to Ambassadors of Peace and Goodwill Peace Ambassadors and other celebrity advocates, including their designation and status. DPI will also facilitate the sharing of information and best practices in the management of relationships with Ambassadors of Peace and Goodwill Ambassadors. 32. The Goodwill Ambassador and Ambassador of Peace shall upon his/her appointment be presented with a communication package including the top priorities of the organization, latest facts and figures and key messages. The latter are to be updated regularly by the focal point. Page 6 of 13

33. Each Agency focal point shall compile a short annual report of activities, which will be transmitted to DPI (following a common template). In turn, DPI will compile all submissions into a joint report. Termination 34. The designation of a Goodwill Peace Ambassador or Ambassador of Peace shall be terminated if, in the view of the Head of the relevant CPS Agency, the designee is unable or unwilling to carry out the role envisaged in the terms of reference, if the Ambassador of Peace or Goodwill Ambassador engages in any activity incompatible with his/her status or with the purposes and principles of the Centre for Peace Studies, or if the termination is in the interest of the Organization. All nomination documents should be emailed to the CPS Secretariat, followed by a hard copy of the documents via registered post. Please address the nomination to: The Chairman Peace Award Committee, Centre for Peace Studies 08, Ali Vanniyar Road, Sammanthurai. Sri Lanka Email: peaceambassador2017@gmail.com The final deadline for submissions is on or before28 th May every year Submissions received after the deadline will not be accepted or considered. SELECTION AND EVALUATION OF FINALISTS All applicants agree that, in the event that their project is selected among the Finalist projects, it will be visited by external experts before any announcement by CPS is made on their selection. This assessment will be conducted by external evaluators onsite most probably during the months of April-May-June-July. Awarding ceremony scheduled in September 21. Changes will be notified. JURIES CPS chooses the Pre-Jury and the Jury independently. This choice cannot be disputed. PRE-JURY A Pre-Jury, constituted of a team of educational experts, will be responsible for evaluating the initial applications and will propose a shortlist of Finalists based on their judgment of the information provided in the application forms. JURY The shortlisted applications of the Finalists will be reviewed by a Jury, composed of prominent educational figures, drawn from governments, civil society, the private sector, international organizations, universities and social entrepreneurs. The Jury will select the winning candidates. Prior to any decision by the Pre-Jury and the Jury, and during the entire selection process, CPS and/or the Pre-Jury or the Jury reserve the right to ask for clarification or complementary information or documentation from the applicants. In addition, information provided by applicants will be reviewed and in the event of any false or inaccurate information, the application will be deemed invalid. Page 7 of 13

Please attach all supporting documents related to your work. The supporting documents (i.e. photos and appreciation letters) will help you to gain more marks. Note: Successful applications normally take between 4-8 months to get from the stage of filling in the application form to consider for Peace Ambassador Award. We do not interview people more than a year before they are eligible for the award. The following Documents should be attached with the Application form. It is mandatory Checklist No List of documents Mark 01 Duly filled Application form 02 Project Statement (see 6.1 ) 03 Project Statement (see 6.2) 04 Complete Curriculum vitae (CV) 05 Copy of Birth Certificate 06 Copy of National Identity card or Passport 07 Passport Size Photographs (05) 08 All Educational certificates 09 Supportive documents to proof your social service or Activities 10 Certified copies of awards and certificates received to your achievements. 11 CPS Membership fee US$ 200 or equivalent (Local / SAARC Regions) 12 CPS Membership fee US$ 300 or equivalent (International) 13 Application fee (1000/=) payable slip (non refundable) Note: When your application is rejected on valid reasons, your membership and awarding ceremony fee will be redeposit to your account. All payment with CPS should be deposited to the account. No direct payments are accepted. You will receive official receipt to your payment within 7 working days or obtain the official paying receipt from the CPS office. Award categories: Democracy and Human Rights Health Peacebuilding Media Community Reconciliation Religious Harmony Education Good Governance Women Development Youth Development and Child protection Sports Art Page 8 of 13

NOMINATION FORM Nominations are called by the Centre for Peace Studies for the CPS-International Peace Ambassador of the year award. This prestigious honor is awarded to an individual or an organization that has made a significant contribution towards diminishing collective violence with increasing harmony that enhances of human potential. The nomination should provide an overall profile of the nominee and his /her specific contributions towards peace-building. Summary documentation with referees is sufficient. Additional information may be requested. The nomination should be proposed and seconded by a CPS member and/or a member institution. The nomination document of 500-1000 (You can submit in local Language too) words should be accompanied by the duly filled application of the nominee, duly certified by the nominee. 01. PERSONAL FULL NAME (Dr/Mr/Miss/Mrs). NAME WITH TITLES AS REQUIRED IN CERTIFICATE (IN BLOCK LETTERS)...... DATE OF BIRTH:... N I C NO:.......... COUNTRY:.PASSPORT NO:...... PLACE OF BIRTH:... G N DIV:.... PROVINCE:. DISTRICT: RESIDENTIAL ADDRESS.. OFFICIAL ADDRESS...... TEL: (Res.):... TEL (Work):... (Mobile):. E MAIL ADDRESS:..... Page 9 of 13

02. ACADEMIC & PROFESSIONAL QUALIFICATIONS Please tell us about any formal, trade or vocational training or education you have received from high school onwards. Please do not use abbreviations. From: Month and year To Month and year Qualifications gained Name and location of Institute Please attaché all supportive documents to proof your education 03. OCCUPATION Present: (Private/State/International/Defense/Semi Government) NAME AND ADDRESS OF ORGANIZATION............ 04. How did you hear about this program : 4.1 News paper: (Name of the News paper):. 4.2 Internet:... 4.3 Facebook:.... 4.4 Friends ( give the following details) Name :.. Address:.....l.... Occupation: Home TP number:...work TP number:.. Mobile No:.. Fax number:... Page 10 of 13

5. Criminal convictions can have a bearing on your eligibility to obtain an award. 5.1 Have you been convicted of a criminal offence in the last 5 years?:... 5.3 Do you have any criminal proceedings pending?:..... 5.3 If you have answered yes, please give details below or attach a separate sheet. 6. About Your Project Please answer the following question 6.1 and 6.2 in 250 words or less. (Be specific in your answers, but please stick to the word limit). You can submit in your local Language with English translation. 6.1 What is your peacemaking project?.. 6.2 Tell us what you did to be a peacemaker and what change you created in your community. (If you have answer, please give details in a separate sheet) 6.3 What is the earliest date you would be available to start your activities?:... The majority of volunteer activities are for minimum of two 200 300 hours in a year. 6.4 Are you prepared to commit yourself for this period? :... 6.5 If not, how long are you prepared to go for? Why? :.... 6.6 Have you ever applied to Peace award through CPS before?: 6.7 If so, In which year had you applied?:... 6.8 What was the outcome?:... 7.Referees Referees must not be related to you. Short listed applicants will be sent the reference forms for the completion of the references indicated below. 7.1 Personal reference Someone who has known you well in a social capacity for at least two years. Name :.. Address:... Page 11 of 13

Occupation: Home TP Number: Work TP Number: Mobile No: Fax Number: Email Address:... How do they know you?: 6.2 Professional reference Someone who can comment on your professional skills; e.g. a tutor, a recent employer, or client if self-employed Name :... Address:..... Occupation: Home TP number: Work TP number:... Mobile No: Fax number: Email Address:. 8. Declaration I declare that to the best of the information I have given is correct. I also accept that CPS will only proceed with my application subject to check with the referees and the authorities which I mentioned in this application and I declare that it is CPS policy. I declare that I have never been convicted of a sexual offence, or dismisses from a post working with children, the elderly or disable for malpractice. I am willing to undergo a police check if required. I understand that any misrepresentation or material omission made on this application form or other document requested by the Organization renders a staff member of the CPS liable to termination or dismissal. Signature of the Applicant. Date Page 12 of 13

Affirmation "I, do solemnly, Sincerely declare and affirm that I will faithfully perform the duties and discharge the functions of the CPS- International Peace Ambassador in accordance with the Constitution of the Centre for Peace Studies, Sri Lanka and in accordance with the Constitution of the Democratic Socialist Republic of Sri Lanka and the law, and that I will be faithful to the Republic of Sri Lanka and that I will do the best of my ability uphold and defend the Constitution of the Democratic Socialist Republic of Sri Lanka. Date:. (Signature) Name:. Attestation (Should be attested by a JP or an Attorney at law) Mr.... of...., and holder of NIC /Passport No: read and understand the Guidelines for the Designation of Ambassadors of Peace and Goodwill Peace Ambassadors in English and his mother tongue signed before me in. on Date : JP/Attorney at Law/Divisional Secretary. Attester s Signature Official stamp here Page 13 of 13