Application form for TTT Workshop for South and Central Asia 
5-7 November 2008

 

UNESCO TRAINING-THE-TRAINERS IN INFORMATION LITERACY WORKSHOP FOR SOUTH AND CENTRAL ASIA

5-7 November 2008

Punjabi University, Patiala (India).

Participant Application Form

Date:____________________

 

                                                                                                      

1.  NAME, ADDRESS AND PERSONAL CONTACT INFORMATION (include email address and current position title)

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2.      EMPLOYER NAME AND ADDRESS

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3.      ACADEMIC CREDENTIALS (identify both undergraduate and graduate degrees, awarding institutions and dates received)

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4.      IS EMPLOYER OR OTHER ‘THIRD PARTY’ WILLING TO DEFRAY TRAVEL AND LIVING EXPENSES IF APPLICANT UNABLE?  NEITHER UNESCO NOR THE HOST INSTITUTION CAN PAY FOR THE APPLICANT’S EXPENSES.  (Circle response; provide any explanation or amplification in space provided, such as pending efforts to identify needed financial assistance)

 

YES                       NO

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5.      REASON FOR WANTING TO ATTEND THE WORKSHOP (include brief description of how you apply and use information literacy in your work, such as teaching or research, and whether you would be willing to share your experiences and approaches at the workshop, including a short presentation)

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______________________________________________________________________________________________________________ 6. DISADVANTAGED POPULATIONS FOR WHICH INFORMATION LITERACY TRAINING WILL LATER BE PROVIDED BY THE TRAINEE (e.g. women, young adults, unemployed, disabled persons, migrant populations, etc.; specify “none” or “general” if no particular special populations)

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7.      LANGUAGE PROFICIENCIES (list the language(s) for which you have a working level of usage; this question is intended to ensure that the applicant is able to participate effectively in, and communicate easily with trainee colleagues and presenters at the workshop applied to) 

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8.      OTHER COMMENTS (for use if you wish to amplify your application with information not provided for in the preceding questions)

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 Applicants should send the completed form to: 

Dr Jagtar Singh

Professor and Workshop Coordinator

Department of Library and Information science

Punjabi University, Patiala 147002 (Punjab) India

Tel: +91-175-3046179, 3046180

Fax: +91-175-2283073

Email: TTTW.Patiala@gmail.com

Website: http://tttw.patiala.googlepages.com/home