Developing Nation Student Enrollment Form
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1. Course number you are enrolling in. *
Ex. OL 101
2. Course Certificate: Your first name and middle name as you would like them (if you wish to use your middle name) to appear on the certificate. Certificates are generated automatically so think carefully. *
Ex. Timothy - or Timothy Sean
3. Course Certificate:  Your last name or last names as you would like them (if you wish to use two last names) to appear on the certificate. Certificates are generated automatically so think carefully. *
Ex. Magee - or Magee Smith
4. Email address that you want to use for the course. Choose carefully; this is difficult to change. *
5. Where did you hear about our courses? Please be specific. If you heard about it from a newsletter or email alert – which one? If it was a from a friend – where did they hear? If it was from the Internet – how: did you Google ‘sustainable development – or was it from a link at another site? Which site? *
Ex. Idealist.org email alert.
6. What is your country of origin? *
Ex.: United States
7. The name of your organization, or the  name of your University - or the fact that you are exploring career options. *
Ex. Center for Sustainable Development. Or, University of Nairobi. Or, I'm interviewing for work in development.
8. What is your job title, and what do you actually do. If a student, what field do you study? *
Ex. Water and Sanitation Specialist. I promote water filters in village homes. Or, I am a student majoring in forestry.
9. What is your organization's/University's website address including http:// please. *
10. Gender *
Ex. Male
11. Why are you taking the course? *
Ex. I want to make a career transition. Or, I want to learn how to work with donors better. Or, I want to have greater success in my projects.
12. What are you hoping to get from the course? *
Ex. I’m hoping to learn how to design effective projects that can improve children’s health in the communities where I work.
13. Your town where you work. *
Ex.: Guatemala City.
14. Your country where you work. *
Ex. Guatemala
15. Is where you work urban or rural? *
Ex. Urban
The next three questions are about whether you or your organization work on development projects where you have the opportunity to talk to community members about their lives?
Answer only one of these questions: 16a, 16b, or 16c.
16a. If you have access to community members, would you be willing to partner on your class project with another course participant who doesn’t? Partnerships have the richest course experiences and seem to have the most successful projects. Open this link up in a separate window to see why: http://www.csd-i.org/partnerships-solo-projects/
Ex. Yes I have contact with beneficiary communities and yes I would be willing to partner.
16b. Or, if you don’t have access to a community, would you be willing to partner on your class project with a course participant who does?  Partnerships have the richest course experiences and seem to have the most successful projects. Open this link up in a separate window to see why: http://www.csd-i.org/partnerships-solo-projects/
Ex. No, I don’t have contact with beneficiary communities and yes I would be willing to partner.
16c. Virtual projects. This is allowed but our experience is that solo/virtual students are less likely to have as rich of an experience nor are they as likely to complete courses as partnerships. Open this link up in a separate window to see why: http://www.csd-i.org/partnerships-solo-projects/
No, I don’t have contact with beneficiary communities. I would like to work on a virtual project.
17. People in remote parts of the world seem hungry for good development information. We would like to make these courses more accessible to more people. If you know of a newsletter, blog, newsgroup or listserve where we would be able to post course announcements—that information would be very helpful. *
Ex. I also subscribe to Development Issues Update from Dev-Zone Global Focus: http://www.globalfocus.org.nz/ . You might contact them.
18. These questions are only for persons requesting the $50.00 Developing Nation Scholarship. Some may be repetitive -- please answer them.
No answer needed in this question.
18a. Were you born in and are you a citizen of a developing nation? *
Ex: Yes.
18b. If yes to question 1, which country is it?
Ex. Guatemala.
18c. Do you live full time in a developing nation? *
Ex: Yes.
18d. If yes to question 2, which country is it?
Ex. Guatemala.
18e. Were you born in, are you a citizen of, do you hold a passport of, or do you have residency in a developed nation? *
Ex. No.
18f. If yes to question 5, which country is it?
 Ex. None.
18g. Do you live part-time or full time in a developed nation? *
Ex. No.
18h. If yes to question 7, which country is it?
Ex. I live in Guatemala
19. Do you want to work on a Northern Nonprofit project in a developed nation or an International Development project in a developing nation? Your choice!
Ex. I want to work on an International Development project.
20. Your name that friends call you and you would like us and other students to call you.
Ex. Tim
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This form was created inside of Center for Sustainable Development.