TropEd Summer School registration form

Registration TropEd Summer School

Personal Data

Please provide the following information about yourself.

I am interested in obtaining a Certificate of Attendance (at least 80% attendance)

I am interested in attending only some of the sessions (less than 80% attendance)

Title *

First Name *

Surname (as stated in passport) *

Address of residence

Post code

City

Country of residence

E-Mail-Address *

Phone number (including country code)

Date of birth (DD.MM.YYYY)

Nationality *

male

female

non-binary

prefer not to say

Professional background

Please provide the following information about your professional background.

I am a student

Name of current employer/higher education institution *

Your job position (e.g., researcher, lecturer, clinician etc.)

Education

Please provide information about your academic degrees - in chronological order.

Degree 1 *

Field of study (Degree 1) *

Duration of study (MM/YY – MM/YY) (Degree 1) *

Name of institution (Degree 1) *

Degree 2

Field of study (Degree 2)

Name of institution (Degree 2)

Duration of study (MM/YY – MM/YY) (Degree 2)

Degree 3

Field of study (Degree 3)

Name of institution (Degree 3)

Duration of study (MM/YY – MM/YY) (Degree 3)

Language skills

The tropEd Global Health Summer School is held in English. Therefore, participants have to be proficient in spoken and written English.

Please indicate your level of English language proficiency: * *

Statement of motivation

Please provide a brief statement (max. 2000 characters) outlining why you would like to attend this course and what benefits you hope to gain from participating in it.

Statement of motivation *

Data Protection Policy

I have read and understood the Data Protection Policy (to be found at https://www.bnitm.de/en/privacy). *

Send

After filling in the form please check your data and press "Submit". You will receive a confirmation email with your registration information.
Should you get an error message, please check your entered data in the marked fields.
Should you have any questions, please send an email to tropedsecretariat@gmail.com.

Kontakt

Dr. Dewi Ismajani Puradiredja

Registration TropEd Summer School