AALCO Hong Kong Regional Arbitration Centre (“AALCO-HKRAC”)EMPANELMENT ON THE AALCO-HKRAC PANEL OF ARBITRATORS APPLICATION FORM PERSONAL DETAILSSALUTATION *MR.MS.DR.PROF.OTHERSALUTATION *FAMILY NAME *GIVEN NAME(S) *DATE OF BIRTH *NATIONALITY *PLACE OF BIRTH *COMPANY/BUSINESS NAME *COMPANY/BUSINESS ADDRESS *COMPANY WEBSITERESIDENTIAL ADDRESS *EMAIL ADDRESS *MORE EMAIL ADDRESSEMAIL ADDRESS 2 *MORE EMAIL ADDRESSEMAIL ADDRESS 3 *MORE EMAIL ADDRESSEMAIL ADDRESS 4 *MORE EMAIL ADDRESSEMAIL ADDRESS 5 *PREFERRED CONTACT NUMBER *FAXCURRENT PROFESSIONAL ACTIVITIES AND POSITION(S) * ADMISSION TO LEGAL PROFESSION Please list any jurisdiction in which you are a legal professional or authorized practitioner.HAS JURISDICTIONJURISDICTION *YEAR OBTAINED *HAS OTHER JURISDICTIONJURISDICTION 2 *YEAR OBTAINED *HAS OTHER JURISDICTIONJURISDICTION 3 *YEAR OBTAINED *HAS OTHER JURISDICTIONJURISDICTION 4 *YEAR OBTAINED *HAS OTHER JURISDICTIONJURISDICTION 5 *YEAR OBTAINED * AREA OF EXPERTISE *AccountancyAgencyAnti-Corruption and FraudArbitrationAviationBankingBuildingCommercialCommercial FraudCommodities and International Sale of GoodsCompany FormationConstructionCorporateCross Border Investment DisputesCryptocurrencyData PrivacyEmploymentEnergyEngineeringEntertainmentEnvironmentalFinanceGovernanceGovernmentHotel & LeisureHuman ResourcesInformation TechnologyInitial Public OfferingInsolvencyInsuranceIntellectual PropertyInternational Business TransactionsInternational TradeInvestment TreatyJoint VenturesLandlord and TenantLegal - Civil LawLegal - Common LawLife ScienceManagementManufacturingMaritimeMedical NegligenceMergers and AcquisitionsMiningNFTODRPartnershipPersonal injuriesPharmaceuticalsPrivate EquityProfessional NegligenceReal EstateSecuritiesShareholders DisputeShippingShipbuildingSocial Work AffairsSportTaxTechnology, Media and TelecommunicationsTransportationTrustOthers(please specify): * PROFESSIONAL MEMBERSHIPS Please list any professional memberships you hold that are relevant to this application.HAS MEMBERSHIPPROFESSIONAL BODY *TYPE OF MEMBERSHIP *YEAR OBTAINED *HAS OTHER MEMBERSHIPPROFESSIONAL BODY 2 *TYPE OF MEMBERSHIP *YEAR OBTAINED *HAS OTHER MEMBERSHIPPROFESSIONAL BODY 3 *TYPE OF MEMBERSHIP *YEAR OBTAINED *HAS OTHER MEMBERSHIPPROFESSIONAL BODY 4 *TYPE OF MEMBERSHIP *YEAR OBTAINED *HAS OTHER MEMBERSHIPPROFESSIONAL BODY 5 *TYPE OF MEMBERSHIP *YEAR OBTAINED * ACADEMIC QUALIFICATIONS Please list any relevant academic qualifications (e.g. undergraduate or postgraduate degree, diploma, etc).HAS ACADEMIC QUALIFICATIONORGANISATION AND QUALIFICATION *GRADE *YEAR OBTAINED *HAS OTHER ACADEMIC QUALIFICATIONORGANISATION AND QUALIFICATION 2 *GRADE *YEAR OBTAINED *HAS OTHER ACADEMIC QUALIFICATIONORGANISATION AND QUALIFICATION 3 *GRADE *YEAR OBTAINED *HAS OTHER ACADEMIC QUALIFICATIONORGANISATION AND QUALIFICATION 4 *GRADE *YEAR OBTAINED *HAS OTHER ACADEMIC QUALIFICATIONORGANISATION AND QUALIFICATION 5 *GRADE *YEAR OBTAINED * ARBITRATION EXPERIENCE PARTY’S COUNSEL *YESNOFREQUENCY OF ACTING AS COUNSEL *ACTED AS AN ARBITRATOR *YESNO1st Appointment *(please specify year)0 / 4NO. OF APPOINTMENTS AS AN ARBITRATOR *NO. OF AWARDS RENDERED *LIST ANY INSTITUTIONAL EMPANELMENTS *OTHER DISPUTE RESOLUTION EXPERIENCE *Please provide a description of the type (e.g. online dispute resolution or use of LawTech) and duration of experience, number of appointments, number of decisions rendered (if any), institutional affiliations and any other relevant information. LANGUAGES Please specify all your language proficiencies (including English). Scale: E = Excellent G = Good F = FairLANGUAGE *WRITINGE: ExcellentG: GoodF: FairSPEAKINGE: ExcellentG: GoodF: FairTECHNICAL TERMINOLOGYE: ExcellentG: GoodF: FairOTHER LANGUAGELANGUAGE 2 *WRITINGE: ExcellentG: GoodF: FairSPEAKINGE: ExcellentG: GoodF: FairTECHNICAL TERMINOLOGYE: ExcellentG: GoodF: FairOTHER LANGUAGELANGUAGE 3 *WRITINGE: ExcellentG: GoodF: FairSPEAKINGE: ExcellentG: GoodF: FairTECHNICAL TERMINOLOGYE: ExcellentG: GoodF: FairOTHER LANGUAGELANGUAGE 4 *WRITINGE: ExcellentG: GoodF: FairSPEAKINGE: ExcellentG: GoodF: FairTECHNICAL TERMINOLOGYE: ExcellentG: GoodF: FairOTHER LANGUAGELANGUAGE 5 *WRITINGE: ExcellentG: GoodF: FairSPEAKINGE: ExcellentG: GoodF: FairTECHNICAL TERMINOLOGYE: ExcellentG: GoodF: FairGENERAL AVAILABILITY TO ACCEPT APPOINTMENTS *ESTABLISHED AND RECOGNISED REPUTATION IN YOUR FIELD *Please list any professional recognition(s) (e.g. awards, rankings in professional directories, etc.) you have achieved during the course of your career.ADDITIONAL INFORMATION (optional)Please provide any additional information relevant to your application.UPLOAD FILESDrag and Drop (or) Choose FilesNotes Please fill in all sections in block letters. If there is insufficient space, provide details on a separate A4 sheet in the same format. In case any section of the form is not applicable, please put in N/A. Upon satisfactory assessment I authorise AALCO-HKRAC to use information that I have submitted for the purposes of promoting and administering the arbitration and other alternative dispute resolution proceedings. Personal Data (Privacy) Ordinance Notice Persons who supply data in their application to the AALCO Hong Kong Regional Arbitration Centre (AALCO-HKRAC) are advised to note the following points pursuant to the Personal Data (Privacy) Ordinance of Hong Kong. Personal data provided in this application form will be used solely for the purpose of assessment for AALCO Hong Kong Regional Arbitration Centre panel listing, and in this connection the data herein will be dealt with by the AALCO-HKRAC staff and/or by the relevant committee members. After an application for assessment has been duly processed, the application papers of the candidates will be retained in a file established by the AALCO-HKRAC for each applicant. Such information will be retained by AALCO-HKRAC for as long as it deems necessary or useful. Under the provisions of the Personal Data (Privacy) Ordinance, an applicant has the right to request access to, and the correction of, his/her personal data as retained by the AALCO-HKRAC. Applicants wishing to access or make corrections to their data should submit written requests to the AALCO-HKRAC. Declaration I have read and agreed to the Personal Data (Privacy) Ordinance Notice. I authorise the AALCO-HKRAC, its staff, employees and/or members of the AALCO-HKRAC to deal with, utilise and/or assess the data submitted by me, as may be required, in connection with my application for inclusion on the AALCO-HKRAC Panel. I understand that my data will become a part of the AALCO-HKRAC files and may be used for all purposes deemed necessary or useful by the AALCO-HKRAC. I declare that the information given in support of this application is accurate and complete. I understand that any misrepresentation will disqualify my application and may lead to revocation of my inclusion of the AALCO Hong Kong Regional Arbitration Centre panel of arbitrators, should I be successful. I confirm that I am familiar with and will adhere to the Terms of Empanelment on the AALCO-HKRAC of Arbitrators and the AALCO-HKRAC Platform Arbitration Rules. Any information on this form may be made available by AALCO-HKRAC to third parties for the purpose of AALCO Hong Kong Regional Arbitration Centre panel inclusion and selection. I have forwarded my up-to-date resumé along with this application form and I have submitted the same to the Director of the AALCO-HKRAC via the email address [email protected] on (insert date of submission by email) . I authorize AALCO-HKRAC to publish such resume on the AALCO-HKRAC website. Please sign below to confirm your agreement to the disclosure of the information contained in the application and your confirmation of its accuracy.SIGNATURE *Start signing your signature hereYour browser does not support e-Signature field.DATE *FULL NAME (in print) *Submit Form