3: Training Application Form


A: TO BE COMPLETED BY THE APPLICANT
Please indicate the course title and dates
1. PERSONAL DATA
Name:
Sex:
Age:
Postal/mailing address
Telephone:
Fax:
Email:
2. EDUCATION BACKGROUND
Highest level attained and year:
Discipline(s)
Institutions and countries where obtained
Other relevant education/training
3. EMPLOYMENT RECORD
Present Occupation/Title of Post
Name of employer
Address
Telephone:
Fax:
Email:
Description of your work
Employed in this position since
Previous working experience (Please mention dates employed, title of posts and give a short
description of your activities)
4. SHORT COURSES ATTENDED
Describe your exposure to professional  training if any (possibly with reference to gender issues). Be clear about content, methods, objectives and participants. 
5.TRAINING EXPERIENCE (IF APPLYING FOR TOT)

Describe  your experience in the field  of training (With major focus  on gender issues ) Clarify your role: Trainer, co- trainer, resource person etc. Please indicate if you have been trained as a trainer (where, when, duration) 

Please tick the following if you are in agreement:

  • If selected, I commit myself to fully participate in the programme and ensure that payment
    is settled before the training starts.
  • I (or my organisation) am (is) able to cover the costs of the training fees, and travel to
    and from the venue of training.
Date:
B: SPONSOR DETAIL
Name of sponsoring agent
Address
Telephone:
Fax:
Email:

Organisation’s/Sponsor’s expectation of the workshop:
C: ACCOMMODATION

Please indicate if you need information or bookings for accommodation

MODE OF PAYMENT**
Fees can be paid in Tanzanian shillings or US$
By Bank transfer (Telegraphic Transfer) To:

Tanzania Gender Networking Programme (TGNP)
P.O. Box 8921, Dar es Salaam.
Fax: 255 22 2443244

** Bookings will only be valid when fees are fully paid. Cancellations received 10 days before beginning of the course will be subject to a charge of T Shs. 50,000/= (fifty thousand).

No refund will be made for any cancellation received thereafter, Delegates may howerver be substituted at any time with prior agreement with the course coordinator.

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Updated: 24 May 2004.
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