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Regional Communications Certification Program
Application form
Full Name (please provide your name as it appears on your passport for travel considerations) *
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Please provide your passport number (for travel purposes)
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Passport Expiration Date
MM
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DD
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YYYY
Passport Country of Issuance
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Mobile Phone (please include area code)
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Email (An email must be provided if you cannot provide a mobile phone number)
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Preferred Messaging Application (GSAC will send you program notifications and travel information) *
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Current Home Address (a. City b. State/Province c. Country d. Zip/Postal Code) *
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Date of Birth (date/month/year) *
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Place of Birth *
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Gender *
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Nationality (please note dual and former citizenship if applicable) *
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Please briefly describe your educational background (including university and degree received) *
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Where are you currently employed? (Current Employer) *
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What is your professional title? *
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Please list your previous occupations *
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What is your level of English proficiency? *
Please describe your personal motivation to attend this certificate program. *
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Please describe if your organization is in a start-up phase, has applied for official registration, operates under a formally recognized or registered status, or other status? *
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Please describe the communications you and/or your organization (company, not-for-profit, etc…) currently use to reach stakeholders. *
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Please briefly describe your competencies using social media and other digital communication platforms. *
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Please provide any additional information that might be of relevance to the admissions committee. *
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