APPENDIX II
Application form/Expression of interest
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Personal detaIls |
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First name |
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Last name |
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Date of birth (dd/mm/yyyy) |
Nationality |
Gender (M/F) |
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Permanent address |
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Postal code |
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Town |
Country |
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Place of work |
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Address of the employer |
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Telephone (with country and city codes!) |
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Mobile |
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Emergency contact details |
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DETAILS OF THE NOMINATING ORGANISATION |
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Name of organisation |
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Postal address |
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Zip code |
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City |
Country |
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Email address |
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Telephone |
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Fax |
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Brief info about your organisation (field of work, activities etc.) What are your role and tasks within your organisation? |
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What are your expectations from this event and how can you use the gained knowledge in your work? |