III Regional Ethics Teacher Training Course

From 13 to 16June 2017
in Port of Spain – Trinidad and Tobago

APPLICATION FORM

Please send this form when completed to Sra. Victoria Suarez
Call for candidates: open from 1st of February - 15thof April, 2017 (or until capacity is reached)

READ: IMPORTANT

1- This training is intended for in-service teachers who have educational responsibilities. Please verify the relevance of your application (Will not be accepting bioethics professionals who do not have current educational task).

2. -The UNESCO organizationwill be responsible for registration fees, experts’ teaching hours, bibliographic materials, and lunches during the 4 days of activities. The participant will assume the expenses of the travel, transport, accommodation and food outside the training hours.

PERSONAL INFORMATION
FirstName
Surname
Gender
Age
Country
City
Address
Landlinenumber
Mobile number
E-mail
ACADEMIC BACKGROUND
Graduatedegree (University)
Postgraduatedegree (University)
WORKING PRACTICE
Institution where the applicant currently works
Date of admission in this institution
Position/Office
Role, Function
Formal places where the applicant teaches ethics or bioethics, if any:
(pleaseattach a scanned institutional certificate) / -
-
-
-
BIOETHICS FORMATION
Received formal training or similar in ethics or bioethics?
YES
NO
Briefdescription:
Last training received in bioethics:
Training in teaching or in pedagogy? Which? (title, university)
Why do you want to participate in this activity?
How are you going to apply the knowledge in your teaching practice?

Authorizations:

Attach a scanned certification, if any, of your work as a bioethics teacher.

If your participation is a personal venture, please attach a note indicating that you are in a position to cover its cost.

If you have been selected by an institution to participate, please attach a note indicating that it allows your participation, as well as it will cover your expenses.

WE ARE GRATEFUL FOR YOUR INTEREST AND ARE WAITING TO MEET YOU IN THE NEAR FUTURE!

1