AMSA UNDIP 2015 APPLICATION FORM

personal details
Title
First name
Last name
Gender
Status
Date of birth
Nationality
Address
Phone
Mobile
Email
Spoken language
Written language
Other interest/skills

: Mr./Ms.
:Chandra
: Manapa
: Male
: Single
: Kalabahi,11-06-1995
: Indonesia
: Gondang timur no 68
: 089690533503
: : chmanapa95@gmail.com
: Indonesia
: Indonesia
: -

Division that you want to apply

1. Member and development
2. Research and academic

organizational experiences

participation in AMSA activities (local, national, international)

LOCAL

NATIONAL

Name of Event
-

Time and Place

Position / Contribution

Name of Event
NAE

Time and Place

Solo, december
2014

Position/ Contribution
Debate team

participation in other activities (other organizations)

participation in trainings

Please answer the questions below honestly, shortly, and clearly. Its up to you whether to answer in Bahasa or
English

Motivation in AMSA
Please explain your motivation in joining AMSA.

Bagi

saya

AMSA

adalah

salah

satu

organisasi

yang

baik

untuk

mengembangkan bakat anak-anak Fakultas Kedokteran. Di AMSA banyak

sekali yang saya dapatkan seperti debate, pengabdian masyarakat, dll. Yang
mana pengalaman ini sulit untuk didapatkan bila berharap hanya dari kelas.
Selain itu saya juga banyak berkenalan dengan anak-anak dari luar
universitas baik tingkat indonesia maupun international. Oleh karena itu,
saya juga ingin turut berpatisipasi dalam organisasi ini agar tetap
berkelanjutan dan membawa dampak yang sama terhadap member barunya
nanti.
Knowledge of AMSA and AMSA-Undip in General
AMSA International was founded in 1985 in Manila, and consists of nine
countries: Indonesia, Australia, Japan, South Korea, Hong Kong, Malaysia,
Taiwan, Thailand, and the Philippines. AMSA Indonesia consists of six
districts, with a total of 26 university members. AMSA Indonesia is led by a
regional chairperson, and our current regional chairperson is Amgah from
Universitas Gajah Mada (District 4). While AMSA International holds three
annual events (EAMSC, AMSC, AMSEP), AMSA Indonesia holds five annual
national events: Munas, Rakernas, NAE, NLT, and Paper & Poster Training.
AMSA-UNDIP was founded in 2003 and belongs to district 4 along with AMSAUNS, AMSA-UGM, and AMSA-UNPAR. We are led by our new representative
Helena

A.K

Cantika

(2013),

continuing

the

work

of

our

previous

representatives, some of which are Christian Tricaesario (2012), Sarah

Dyaanggari (2011), Dwi Rosnia Savitrie (2010), and Edward Sutanto (2009).

In the previous year, AMSA-UNDIP consisted of four divisions: Academic,

Membership and Development, Community Outreach, and Public Relations.
Below Cantikas presidency this year, AMSA-UNDIP consists of five divisions:
Membership and Development, Research and Academic, Publication and
Promotions, Finance, and Community Outreach.

Personal Experience
Please tell us about your personal experiences, activities that you have joined, and your achievements that makes you
suitable for a position in AMSA-Undip. Narrow your descriptions to areas that are related to the position you are applying
for.

Saya pernah mengikuti banyak aktivitas dari AMSA undip termasuk

pengabdian masyarakat, charity concert, dan national AMSA event. Yang
paling mengena bagi saya adalah

Purpose of Application
Please describe what you know of the previous divisions (you can use SWOT analysis) that you are applying for and its
problems. And please give your solutions to these problems. (If you dont know, just say you dont know)

Please explain why you are interested in applying for these positions.

Please describe all ideas that you may have to improve AMSA-Undip through your position as staff. Explain the ideas

systematically and convince us that you are really passionate in actuating these ideas.

With this application form, I am willing to be staff of AMSA UNDIP and I am agreeing my
membership. Should there be any inconsistency with the reality, I am also willing to be
sanctioned according to regulation.

--your digital signature here

Semarang, __ February 2015

______________________