Social Media Lab Kindly Print, Complete All of the Following Data and Scan Or Email To

SOCIAL MEDIA LAB
KINDLY PRINT, COMPLETE ALL OF THE FOLLOWING DATA AND SCAN OR EMAIL TO

PREFIX: Dr. Rev. Mr. Mrs. Ms.

NAME AS IT APPEARS ON PASSPORT:

FIRST NAME: _________________________________________________________________________________________

MIDDLE NAME: _______________________________________________________________________________________

LAST NAME: __________________________________________________________________________________________

CITY & COUNTRY OF BIRTH: _____________________________________________________________________________

GENDER: Male Female

DATE OF BIRTH (MMDD/YYYY) _________________________________

CURRENT PHONE: ____________________________________________

ADDRESS: _____________________________________________________________________________________________

PHONE NO: _________________________________________________

MOBILE NO: _________________________________________________

EMAIL ADDRESS: ________________________________________________________________________________________

ENGLISH ABILITY: 1-Elementary Proficiency 4-Advanced Professional Proficiency

2-Limited Working Proficiency 5-Native Proficiency

3-General Professional Proficiency

I PREFER CLASSES IN:

English
Sinhala
Tamil

WHAT LEVEL OF SOCIAL MEDIA TRAINING ARE YOU LOOKING FOR?

Beginner (Facebook basics; Twitter / YouTube / Linked in fundamentals; Google Search tips)
Intermediate (Advanced Twitter, etc)
Advanced

WHAT KIND OF SOCIAL MEDIA PLATFORMS DO YOU CURRENTLY USE? Please list all social media platforms you regularly engage with (e.g., facebook, youtube, instagram, twitter, google+, etc.) & your handle/page address for each site etc. If you do not use any, please put “None”.

______________________________________________________________________________________________________

TELL US: WHY ARE YOU INTERESTED IN LEARNING ABOUT SOCIAL MEDIA?

______________________________________________________________________________________________________

CURRENT POSITION, ROLES AND RESPONSIBILITIES: Please describe your current work role. If you are in school, please tell us what level, and what you are studying.

______________________________________________________________________________________________________

EXTRA CURRICULAR ACTIVITIES YOU ENGAGE IN:

______________________________________________________________________________________________________