EPDET 2017 DEVELOPMENT EVALUATION TRAINING APPLICATION FORM
Please fill out this preliminary Application Form as soon as possible to reserve a place at the 2017 Development Evaluation Training taking place in Slovakia.
Name of participant *
Your full name as it should appear on correspondence
Contact address *
as it should appear on correspondence
Country of residence *
Country of origin (if different from Country of residence above)
This allows us to show off the varied backgrounds of our participants
Contact telephone *
+XX XXX XXXXXXXX (include country code)
Email address *
Is the email address above correct? *
Please check, as this is our main means of contacting you
Gender *
Date of birth *
DD.MM.YYYY
Name of organization
If you are employed by/represent an institution, please provide its name
Type of organization you work for: *
Please specify other type of organization you work for, if you didn´t choise among options above:
Previous experience with development evaluation or management of evaluations
Clear selection
How did you get information about EPDET? *
Other (please specify):
Participant fee
The registration fee is 1390 EUR. The fee includes accommodation and full board, coffee breaks; and all tuition expenses including training materials for participants. International travel, visa costs and insurance are not included in the registration fee.

For participants staying in their own accommodation in Bratislava, the fee is reduced to 1 140 EUR.

The fee has to be paid by bank transfer before July 31, 2017! After 16 August, no refunds will be provided in case of participant cancellation, at the discretion of the management, substitutions may be possible. In such cases, please contact the EPDET manager.
OTHER INFORMATION
Training and accommodation facilities
Preferred room type *
Special dietary requirements
We will make an effort to meet any special dietary requirements.
Training is limited to 50 participants.
Please note that Vienna airport is very close as well and there is a frequent regular bus connection between the two airports (schedule and costs can be provided upon request).
Invoice Information
We require the following information to accept your application.
Name of person/organization paying EPDET fee, if it differs from the contact details of the participant
Identification/VAT number, if applicable
Name of contact person for invoicing
Identification number or other invoicing details
If you require specific identification information on the invoice, please provide it here
Postal address for invoicing
Telephone number for invoicing
Email address for invoicing
EPDET Manager
Ms. Dagmar Gombitova - mobile phone: + 421 903 711 396 Slovenská evaluačná spoločnosť/ Slovak Evaluation Society SES, Talichova 2, 841 02 Bratislava, Slovakia Phone / fax: +421 2 6545 8981 E-mail: gombitova@evaluacia.sk

Questions or requests for additional information may be addressed directly to Ms. Dagmar Gombitova, EPDET program manager (gombitova@evaluacia.sk)
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