Application form for UNESCO-IHE Refresher Courses

How does it work?

  1. Fill out the form below (please do not use all caps)
  2. Submit the information by pressing the submit button
  3. UNESCO-IHE will now receive your information digitally (please do not send a duplicate application by regular mail)
  4. You will receive an automated e-mail message confirming your application and containing all information you submitted for your personal administration
  5. You will be notified in due time via email whether or not you will be awarded a NFP fellowship.

If you have any problems or need assistance completing this form, please contact us by sending an email to: refresher@unesco-ihe.org

Fields marked with an asterisk * are required.


Course:
Course name Building Flood Disaster Resilience of Cities - Meeting Internal and External Challenges of the Future
Date: 01 Oct 2012 to 11 Oct 2012
Refresher course


Your information:
Family name*
Full name passport*
First name*
Gender*  Male  Female
Date of birth*
Place of birth*
Country of birth*
Nationality*


Your address:
Address type*
Street*
Number*
Postbox number*
Extra info
Postal code*
Town*
Country*
Phone
Mobile
Email*


IHE/UNESCO-IHE courses attended:
Masters/diploma course(s) (name+year)*
Sponsor(s)*
Did you attend any refresher course?*  Yes  No


Education after you have left UNESCO-IHE (if applicable):
University name
Start date
End date
Degree
Main study
Thesis title


Employer:
Job title*
Start date*
Employer/company*
Employer category*
Address type:
Street
Number
Postbox number
Extra info
Postal code
Town*
Country*
Phone
Email
Description of your work, indicating your personal responsibilities (max. 500 characters)*


Your application:
Why do you wish to follow this course? (max. 500 characters)*
Curriculum vitae*
Photocopy of passport (for ticket purposes)*
How do you intend to pay for the course?*
Have you received confirmation of financial support from your sponsor? (if applicable)  Yes  No
I agree to the terms and conditions*
Please retype