CIP - Capacity Strengthening Department
Application for
Individual Trainings
The following information and documents are needed to apply for an Individual Training at CIP:
A.
Name of the course / Topic of the training activity:
*
B.
CIP Division to which the training may correspond
Select an option
1 - Impact Enhancement
2 - Genetic Resources Conservation & Characterization
3 - Germplasm Enhancement & Crop Improvement
4 - Integrated Crop Management
5 - Production Systems & the Environment
6 - Agriculture & Human Health
7 - CONDESAN
8 - Global Mountain Program
9 - Urban Harvest
10 - Papa Andina
11 - PRAPACE
12 - UPWARD
13 - VITA A
Other:
C.
Personal Information:
(for applicants with more than one name, please include):
Firrst and middle names:
*
*
Second name (family name):
*
*
Country of origin:
Complete personal address:
Personal Phone:
Personal E-mail:
*
*
Passport Number:
Issuance Date (mm/dd/yyyy):
Expiration Date (mm/dd/yyyy):
Sex: Male
/ Female
D.
Institutional Information
Institution Name:
Director of the institution:
Type of institution:
NARS:
International:
Private:
Other:
Complete address:
Work position:
Since (yyyy):
Institution (personal) Phone:
Institution (personal) E-mail:
E.
International Health & Life Insurance
Own insurance
AIARC insurance (US$ 106.00 per calendar month)
F.
Funding
The Training will take place upon the confirmation of the bank transference to our accounts.
Own funds
Other (specify):
Data of the institution that pays:
Institution name:
Contact person:
Phone:
Fax:
E-mail:
G.
Attach Documents:
a. Curriculum Vitae
*
b. Institutional letter of presentation
*
c. Scanned image of Passport and visa (if needed)
*
For further information about individual trainings at CIP, please follow this link:
http://www.cipotato.org/training/sships.asp
* Obligatory field