Académique Documents
Professionnel Documents
Culture Documents
ON
SUSTAINABLE WATER MANAGEMENT
Tokyo and Tsukuba, Japan, 27 July – 7 August 2015
PERSONAL DATA
1. Full name:__________________________________________________________
As written in your passport
4. Citizenship:______________________________________
As written in your passport
5. Present Affiliation (Educational institution including Faculty and Department in case of students/ Name of
employer’s organization):__________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
8. Home Address:________________________________________________________________________________
Higher Institution and location Dates (from –to) Period of Degree Major
Education: Year Month schooling
Undergraduate years
level
months
Graduate years
level
months
years
Total years of schooling
(including elementary and secondary education) months
11. List all previous employment, starting with your current employment.
Name of organization and location Dates (from - to) Job title and description (in max. 20 words)
12. Explain your motivation for participating in the course. If you are a student, describe what you are most interested
in and summarize your present research focus. Otherwise summarize your present duties and responsibilities. (max
200 words).
13. English language ability. While we do not request any official certificate of your English language proficiency, we
request your own sound judgment in this respect as the course will be conducted in English and will be concluded by
participants’ presentation in English.
I hereby confirm that my English language skills are sufficient to undertake the subject course that will be conducted
in English:
Yes No
14. The course is designed as a complete unit and no partial participation is allowed. Participants are expected to
attend the full period of the course from Monday 27 July through Friday 7 August 2015.
I hereby confirm that I will participate in the full course from 27 July through 7 August 2015:
Yes No
15. Financial support. Participation in the course is exempted from any tuition fee and the organizers will cover all
costs associated with accommodation and local transportation. Generally, participants are expected to cover the cost of
their travel from their residence to Tokyo and back from Tsukuba and their daily subsistence allowances during the
period of the course. Additional support may be provided to participants coming from developing countries to cover
travel costs between their country and Japan and their daily subsistence allowance during the period of the course.
However it is not automatically assured to every such participant. If you are a citizen of a developing country and
residing presently in a developing country, please respond to the following question.
Will you apply for the additional financial support (please choose one):
Yes, I will.
CERTIFICATION
I certify that to the best of my knowledge all the information given above is correct and complete,
and I understand that any omission or misinformation may invalidate my admission or result in
dismissal.
________________________________________________ _______________________
Signature of applicant Year/Month/Day