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2013 BOULDER MFT - REGISTRATION FORM


Which languages do you speak fluently? *
Title *
First name / Given name *
Family name(s) / Surname *
Gender *
Working information
Institution you work with *
Type of institution *
Institutional web site
Job Title *
Job Type *
Level of responsibility *
Duty station/Work address *
City *
Country *
Phone: (country code) (city code) (phone number) *
Fax n°
E-mail *
Personal information
Second E-mail address
Cel Phone: (country code) (city code) (phone number)
Food Preferences *
Iftar (Ramadan) for catering purposes: *
Please upload your picture in jpg format (max.size 50K)


Do you need a visa to get to the Program? *
First name (as written on passport)
Family name (as written on passport)
Nationality *
PASSPORT N.
Place of issue
Date of Issue (DD-MM-YYYY)
Date of Expiry (DD-MM-YYYY)
Place of Birth *
Date of birth (DD-MM-YYYY) *

This information only refers to your sponsor organization.
TUITION SPONSOR
Type of sponsor *
Name of tuition sponsor *
Contact person *
Sponsor contact's email *
Address *
City *
ZIP code *
Country *
Phone: (country code) (city code) (phone number) /extension
If you already have it, please upload the tuition proof of payment in jpg or pdf format (max.size 100K)
ACCOMMODATION OPTION
Please indicate the accommodation option you choose *
Share the room with:
ACCOMMODATION SPONSOR
Type of sponsor *
Name of accommodation sponsor *
Contact person *
Contact person email *
Address *
City *
ZIP code *
Country *
If you already have it, please upload the accommodation proof of payment in jpg or pdf format (max.size 100K)

After clicking 'Send Registration' below we will be in contact with you regarding the subsequent registration steps (payment, course selection, and accommodations) Please do the following math as a security code:

	I wish to receive Boulder Institute of Microfinance information


Please submit a short bio about yourself (around 10 lines) *
Describe any job/field experience you have had related to microfinance *
How would you rate your knowledge of microfinance? *
Describe any previous training you have had in microfinance, accounting or finance *
Describe your current job and responsibilities *
What are your expectations for the Boulder MFT? What issues concern you most? *
How did you learn about the Boulder MFT program? *
Please let us know if you have any questions or special requirements

Please select the Boulder MFT program you plan to register for in 2013: