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CTA (Technical Centre for Agricultural and Rural Cooperation) Postbus 380 NL 6700 AJ Wageningen The Netherlands Tel: +31 317 467146 Fax: +31 317 460067 Email: paauw@cta.int |
Application for Training Courses
Title and date of course for which you are applying:
Scientific Data Management for Anglophone Countries, INSTI, Accra, Ghana, 12-23 March 2007
Part A: To be completed by applicant (Please type or print in block letters)
Personal
1. Family name-------------------------------------------------------------------------------------------------
2. Other Names------------------------------------------------------------------------------------------------
3. Date of Birth------/---------/-------/
Yr Mo. Day
4. Sex: Male Female
5. Nationality----------------------------------------------------------------------------------------------------
6. Official address for correspondence----------------------------------------------------------------
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7. Telephone--------------------------Fax--------------------------Email-----------------------------------
Education and Training (Post-Secondary only)
8. Formal Training
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Institution (most recent first) |
Period of study Mo./yr. Mo./yr. |
Major field of study |
Diploma or degree obtained | |
9. Other relevant training
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Institution (most recent first) |
Period of study Mo./yr. Mo./yr. |
Major field of study |
Diploma or degree obtained | |
10. Have you received previous training at CTA? Yes No
If yes, please state title of training----------------------------------------------------------------------
Dates. -------------------------------------------------------------------------------------------------------------
Your Organization, Work Experience & Skills
Full Name of your organization---------------------------------------------------------------------------
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11. Type of Organisation
Government Agency
Farmers’ Association
Non-governmental Organisation
Research Institution
12. Sector:
Public
Private
13. Main activities of the Organisation:
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14. Your current job title------------------------------------------------------------------------------------
15. Date appointed------/---------/-------/
16. List your major duties and responsibilities in an order of priority.
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17. List any professional experience prior to your present job.
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18. Computer Skills: Please indicate your computer skills ability using: slight = S, fair = F, good = G.
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Software applications |
Name of software(s) |
Level of Competence |
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Word processing |
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Spreadsheets |
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Database management |
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Statistical Application |
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Internet/Email |
18a. Do you have sole access to an official PC? Yes No
18b. If yes : do you have internet access in your organization at the departemental level?
19. Language competence: Please indicate your language ability using: slight = S, fair = F, good = G.
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Language |
English |
French |
Portuguese |
Other (Specify) |
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Level of Competence |
Expectations
20. What are your personal expectations of this workshop?
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Signature of Candidate-------------------------------------------Date-------/---------/-------/
Part B: To be completed by applicant's Head of Department.
Please note:CTA will not accept self-nominations.All applicants must be nominated by their employers.
21. Name---------------------------------------------------------Job Title------------------------------------
Address-----------------------------------------------------------------------------------------------------------
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Telephone--------------------------------------------------Fax-------------------------------------------------
Email--------------------------------------------------------
22. State the specific skills you expect the applicant to acquire from the training.
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23. Indicate how the applicant will use skills acquired.
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24. What resources will be provided to enable the applicant will use the acquired skills?
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Signature and Stamp-------------------------------------------Date-------/---------/-------/
Please return this questionnaire before --22-/Feb-/2007 to:
Rodger Obubo
Training Programmes Manager
CTA - P.O. Box 380
NL 6700 AJ Wageningen
Tel.: +31 317 467 146 - Fax: +31 317 460 067
E-mail:
Obubo@cta.int| Other available information |