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APPLICATION FORM Civil Society Leadership Institute (CSLI)
Dates: May 08 – 19, 2017 in Accra, Ghana

Application Deadline: Tuesday, 28 February, 2017

Candidate’s Details and General Information
Full Name
Your answer
Nationality
Your answer
Gender
Date of Birth
MM
/
DD
/
YYYY
Do you have a Valid Passport (For non-Ghanaian Candidates)
Expiration Date
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Email Address
Your answer
English Language Profiency Level
Telephone (Mobile)
Your answer
Do you have supervisory responsibilities?
If yes, kindly state the number of Staff you supervise
Your answer
Current position
Your answer
Length of time in that position
Your answer
Number of years of work experience
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Name of your Supervisor
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Supervisor’s Title/Positon
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Supervisor’s phone number
Your answer
Supervisor’s Email Address
Your answer
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