GFMER Adolescent Sexual and Reproductive Health Course 2018 - Application Form
The Geneva Foundation for Medical Education and Research (GFMER) in collaboration with the World Health Organization (WHO) and other partners announces the online training course on Adolescent sexual and reproductive health.

"Meeting the needs and fulfilling the rights of adolescents’ sexual and reproductive health."

Course objectives:
• To identify the needs of adolescents on sexual and reproductive health.
• To know how to respond to these needs.

Course duration: 8 weeks (14 May - 6 July 2018)
Course fee: USD 250

Application deadline: 30 April 2018
Payment deadline: 7 May 2018

Course website:
https://www.gfmer.ch/SRH-Course-2018/adolescent-health/index.htm

Course email:
adolescenthealth@gfmer.org

Brochure:
https://www.gfmer.ch/SRH-Course-2018/pdf/Brochure-2018.pdf

To apply for the course, you should submit this completed application form and send the required enclosures by email to the course email:
1. A curriculum vitae, including sections on current and previous positions
2. A certified copy of diploma(s)
3. A letter of motivation stating clearly your interests and reasons for applying to the Course (1-2 page maximum).

Family name (surname) *
First/other names *
Gender *
Date of birth *
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Place and country of birth *
Present nationality *
Country of residence *
Professional address *
Telephone number with country and area codes
Fax number with country and area codes
E-mail address *
(Please input only ONE valid email address.)
Profession *
Present position *
Period (month/year), title, institution
Previous positions *
Period (month/year), title, institution
Highest Qualification *
(e.g. MD, Ob/Gyn ; MPH ; MBBS ; PhD ; FWACS, Ob/Gyn ; BA; BSc, Certificate; Diploma; etc.)
Education *
Give details in chronological order (date, name of the institution and title of degrees/certificates). Include courses and postgraduate studies in your professional field
Specialty and subspecialty certifications
Professional affiliations/memberships
List of publications
Mother tongue *
English language skills - Speaking *
English language skills - Writing *
English language skills - Reading *
Financing *
If you are accepted to the Course, please indicate, who will finance your participation in the Course
How do you know this course? *
Are you interested in taking other courses in 2018?
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