Name
First name
Gender MF
Nationality
Date of birth
Birth place
Address
Email Address
Phone
Mobile phone
Fax
Name of the Institution
City
Region
Country
Portal or Web Site
Name & first name of the focal point
Position of the focal point
Email Address of the focal point
Phone of the focal point
Fax of the focal point
Highest Academic level —Please choose an option—PhDMaster/ MSc DegreeTwo year Degree/Bachelor DegreeHigh school DegreeSchool-leaver's certificateBelow school-leaver's certificateOther
Areas of Education and Expertise LawEconomy / Finance / AccountingAdministration/Public ManagementTerritorial/Local GovernanceHuman Resources ManagementProject Management/ Marketing/ LogisticsEngineering/ Civil EngineeringInformation Technology and Information SystemsPedagogical Engineering / Educational ScienceEnvironment/Territorial planning/Urbanization/Housing/ArchitectureOrganization and Management of Public ServicesManagement of Social and Cultural AffairsOthers
You are an Elected Official/Female Elected OfficialPublic servants The structure to which you are affectedOther [group group-you_are-elu clear_on_hide] —Please choose an option—Mayor of communePresident of RegionAdvisorPresident of CommissionProvincial Council PresidentPrefectoral Council PresidentOther [/group] [group group-you_are-fonctionnaire clear_on_hide] —Please choose an option—Central administrationSubnational administrationLocal GovernmentsNational Public AgencyLocal Public AgencyOther [/group] [group group-poste_actuel_attache clear_on_hide] Your current position : [/group] [group group-you_are-autre clear_on_hide] [/group]
Number of years in this position —Please choose an option—More than 10 yearsBetween 5 and 10 yearsBetween 1 and 5 yearsLess than 1 year
Number of years of experience : —Please choose an option—Less than 5 yearsBetween 5 and 10 yearsBetween 10 and 20 yearsMore than 20 years
Have you ever benefited from Training and/or Capacity Building Programs in the last five (5) years? (If yes, please specify) YesNo [group group-formation_program clear_on_hide] Name the 5 most important trainings, specifying Organizer, theme, number of days, venue of the training (If yes, please specify) [/group]
Have you benefited from a Training of Trainers? (If yes, please specify) YesNo [group group-formation_former clear_on_hide] [/group]
Are you a Trainer? (if yes, please specify in which field) YesNo [group group-are_you_former clear_on_hide] [/group]
Have you ever benefit from Online courses ? (If yes, please specify) YesNo [group group-formation_distance clear_on_hide] [/group]
Languages EnglishArabicSpanishFrenchPortugueseOthers
Download your cover letter (only for training offers) (pdf, doc, docx, jpeg, jpg) Download your Curriculum Vitae (CV) or biography* (pdf, doc, docx, jpeg,jpg) Download your Picture* (pdf, doc, docx, jpeg, jpg) Download your national identity card or the identification page of your passport* (pdf, doc, docx, jpeg, jpg)* (pdf, doc, docx, jpeg, jpg)
(*) Mandatory field
Who is paying for your participation? Your institutionFinancial institution or donorYourselfOthers
Choose your process of payment Online payment (coming soon)Payment by bank transferOn-site registration payment [group group-paiement_virement]
Name of the bank : BNPPARIBAS
Address :117, Boulevard HAUSSMANN 75008, Paris France
Beneficiary :CITES ET GOUVERNEMENTS LOCAUX UNIS D'AFRIQUE
IBAN/Bank Account number :FR7630004005670001009726629
BIC / SWIFT code :BNPAFRPPINT
Please send proof of payment by email to the following 3 addresses :
Adil ALAMI CHENTOUFI : [email protected]
Fariath CHABI : [email protected]
Philomene DABIRE : [email protected]
[/group]
