Personal Information

Title
—Please choose an option—MissMsMrsMrDrOther

First Name

Surname

Date of birth

Your Nationality

Job title/Occupation

Organisation Name

Postal Address

Country

Telephone Number

Please include country code.

Email Address

Which ONE of these best describes the PRIMARY FUNCTION of your current role?
FunderProgramme ManagementIntervention Design & ManagementMonitoring & Results MeasurementBusiness Development/FundraisingOther

If 'Other', please give details.

Other information: Please tell us a little about your CURRENT role.

(1000 characters)

0

Other information: Why is this course important to you?

(1000 characters)

0

Sponsoring Organisation

For invoicing and payment of the programme fee.

Organisation Name

Contact Person

Postal Address

Country

Telephone Number

Please include country code.

Email Address

Has your sponsor confirmed funding is available for your attendance?
YesNo

Please advise us if there are any specific invoicing procedures we need to follow

(e.g. quoting a purchase order number)

Administration & Logistics

Accommodation

It is your responsibility to make your own accommodation reservation. Due to traffic issues in Bangkok, we highly recommend that participants book rooms at the event hotel (reduced rates negotiated). The hotel accommodation form will be emailed to you with notification of your acceptance onto the programme. If participants choose to stay elsewhere in Bangkok then we recommend that they select accommodation near a BTS Skytrain stop.

Insurance and Liability

It is your responsibility to ensure you have adequate insurance in place. The Springfield Centre cannot be liable for any losses or injury that you, the applicant, sustain, or damage that you cause, during your visit. We request that you make arrangements for appropriate insurance relevant to attending the event, particularly in respect of cancellation, personal health, accident and possessions. You will be personally responsible for all charges and expenses incurred which are not funded by a sponsoring organisation. All charges are due at the time of registration unless you have made alternative arrangements.

By submitting this application, it is assumed that you have read, understood and agree to these terms.

Data Protection

All personal data gathered during the application process shall be used by The Springfield Centre for Business in Development Ltd for the sole purpose of operating this training programme.

This may also include supplying some of your details to the course venue staff.

Following the completion of the course, data will be retained securely for reference purposes only.

Please check this box to confirm you understand how your data will be processed

You can withdraw your consent at any time by contacting us in writing to have your data updated or deleted from our records.

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