ICH - Application form

- Please use separate forms for each course.

- Fields marked with * must be filled inn

- The e-mail address must be a valid address. A

Welcome to
ICH Course Application Form
Please fill out the application electronicly. The form will be sent to ICH
for further processing and selection. A confirmation e-mail will be sent
to given e-mail address.

Course details

Select course:

Will secure own funding Reduced fee for members Apply for NORAD sponsorship

Personal details

Family name:

Gender:

MaleFemale

First name:

Date of birth:

/ / *

Title:

Organization:

Nationality:

Address Office:

Marital status:

Address Home:

Number of children:

Country:

www:

Home phone:

E-mail:

Office phone:

Fax:

Education

University degree (level and field)

Name of university:

Country:

Year:

Work

Years in present position:

Years in present organization:

Duties and responsibilities in your present job/position:

Previous working experience:

Total number of years working experience:

Other information:

Restrictions

Food restriction:

Smoking:

SmokeNon-smoke

Applicant´s knowledge of English:

Excellent/FluentGood/averageVery little experience

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