Registration Form
1. Application  
   
First Name*
Last Name*
   
   

Job Title

Gender*

Male Female
2. Applicant's contact information  

Organization full name*

Department full name

Address*

City*

State/ Province

Country*

Postal code*

Email*

Telephone*

Fax

Mobile

 
3. Applicant's current function*

Head of State (National Level)

Manager

Member of Cabinet

Professional / Technical Staff /       Officer

Other Minister / Deputy Minister

Professor / Teacher / Trainer /       Educator

Legislator / Parliamentarian

Administrative / Support Staff

High Court Judge

Student

Head of Sub-national / Local       Government

Others, Please specify below:

Traditional / Community Leader

 

 
 
4. Type of organization for which the applicant works*

Government Agency

Public Sector Organization

Private/financial sector organization

Academic/research institution

NGO

Donor Agency/IFI

Other

 
5. Why are you interested in taking this course and what are your expectations from the course?*
 
6. Agreement

I certify that all information provided is accurate. I understand that this application will be reviewed and applicants will be selected based on relevant experience and space availability. I also understand that if my participation is subject to clearance by my government or to approval by a particular agency in my country, I will comply with this requirement.

If selected, I understand that my feedback about the learning activity in which I participate can help the World Bank Institute improve its activities in the future. I agree to complete a confidential survey at the end of the learning activity and a few months later if I am asked.

 

I Agree

 
* Mandatory fields