Application Form - 2019 International Training Workshop on Big Data for Developing Countries 23-27 September 2019, Trinidad & Tobago
Closing Date of Application: 31 July 2019
Email address *
Full Name (as in Passport) *
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Designation
Gender *
Nationality *
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Passport Number *
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Date of Birth *
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Organization *
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Applicant's Office Address
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Country *
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Office Phone Number
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Office Fax Number
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Mobile Number
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Official E-Mail *
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Personal E-mail *
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Person to be contacted in case of emergency (Name, Address and Phone)
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Education - Name of institution
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Major field of study / Degree *
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Year of study
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Other Degrees
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Employment Record - Current Post / Title of Post
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Duration of service (years)
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Current monthly salary (US Dollar)
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Name of immediate supervisor and title of post
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E-mail of immediate supervisor *
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Type of organization
Total Number of employees in organization
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Description of your current work including your responsibility (100 words)
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Reasons for applying (100 words) *
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Have you previously participated in any ISTIC programme?
If yes (Name of programme and date)
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English Language Proficiency - Listening
English Language Proficiency - Speaking *
English Language Proficiency - Writing
English Language Proficiency - Reading
Name of Head of Organization
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Address of Organization
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Head of Organization - Phone Number
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Head of Organization - Fax Number
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Head of Organization - E-mail
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Declaration - Have you ever been convicted by a Court of Law of any country?
If Yes, Please give brief details
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I (applicant) certify that my statements in answer to the foregoing question are true, complete and correct to the best of my knowledge and belief. I fully understand that if I am granted an award it maybe subsequently withdrawn if I fail to make adequate progress or for other sufficient cause determined by the host government. *
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