TRAINING COURSE APPLICATION FORM

“Building quality systems for international aid projects”

24 and 25 October 2014 in Kampala, Uganda

Please complete this application form (pages 1, 3 and 4) and send to

Participant details

First name
Surname
Postal address 1
Postal address 2
Post code
Town
Country
Email address
Contact number
Organisation
Job title
Qualifications
Training course / Building quality systems for international aid projects
Course date / 24-25 October 2014
Course location / Kampala, Uganda
Dietary requirements / ☐ YES ☐ NO
(please specify)

To help us prepare this training course, please take five minutes to answer these questions.

How many years have you been working in the development / humanitarian sector?

Have you participated in setting up or running quality management processes? If so, please can you provide a brief description? (e.g. type of activity, purpose, duration, results, etc.)

What role do you hope to play in terms of building or reinforcing quality systems in your organisation? (e.g. setting up, design, coordination, implementation, organisational learning, etc.)

What are you hoping to achieve during this training course?

How did you hear about this training course?

Venue

The training course will take place at Hotel International Muyenga, Kampala, Uganda.

Please read the security note for important security information.

We would sincerely like to thank MSF for their support and for providing the venue for this course.

Training fees

Payable to Groupe URD

Training fees for this training course are UGX 529 600

Training fees include all training resources.

Training fees do not include accommodation, lunch, refreshments, local and international transport, visa and health insurance.

Accommodation and catering

Payable to Hotel International Muyenga on arrival

Accommodation, lunch and refreshments will be provided by the Hotel International Muyenga, Kampala, Uganda.

Option 1): Full board single room (includes breakfast, lunch and refreshments) UGX 278480 per night

Option 2): Lunch and refreshments only UGX 33000 per day

Registration

In order to confirm your place on this course, please return your completed application form and we will send you a training contract. Once we have received your signed training contract and the fees, we will confirm your place on the course.

Registration will take place from 8.00 to 8.30 am on Friday 24 October 2014 in the training room at Hotel International Muyenga, Kampala, Uganda.

Time

The training course will commence at 8.30 am and will terminate at 5.30 pm with a 1hr lunch break from 12.30 to 1.30 pm (16 hours face-to-face training).

Transport, insurance and visa costs

Participants must organise and pay for their own transport (local and international), health insurance and visas.

Training fees

A / N° / Cost (UGX) / Total (UGX)
Training fees (payable to Groupe URD) / 1 / x / UGX 529 600 / = / UGX 529 600

Accommodation and catering

Please select either option 1) or option 2) and indicate how many days accommodation you need.

B / N° / Cost (UGX) / Total (UGX)
Option 1) Single room + full board (breakfast, lunch & dinner)
23 October 2014 / x / UGX 278 480 / =
24 October 2014 / x / UGX 278 480 / =
25 October 2014 / x / UGX 278 480 / =
Option 2) Lunch and refreshments only
24 October 2014 / x / UGX 33 000 / =
25 October 2014 / x / UGX 33 000 / =
TOTAL (payable to Hotel International Muyenga, Kampala)

Payment

Please indicate whether you will be paying your training fees yourself or whether we should invoice your organisation.

1)  I will pay my training fees myself either by bank transfer or Western Union
Bank transfer / Groupe URD’s bank details
Bank Crédit Agricole Sud Rhône Alpes
Branch Buis les Baronnies
Tel +33 (0)4 75 28 28 00
Account no. 13906 00123 85002515607 20
IBAN FR76 1390 6001 2385 0025 1560 720
SWIFT/ BIC AGRIFRPP839
Western Union / Transfer your payment via Western Union. The recipient’s details are:
First name: Anna
Surname: Lear
Branch: La Poste, Place Portalet, 26170 Buis les Baronnies, France
Send a scanned copy of the money transfer voucher with the transfer reference by email to
2)  My organisation will pay my training fees
Please let us know who we should contact at your organisation for invoicing purposes.
Organisation
Contact person
Email address of contact person
Tel no. of contact person
Organisation address
Postcode
Town
Country
Tel no.
3)  I will pay my accommodation and catering costs direct to Hotel International Muyenga, Kampala on arrival

Groupe URD, La Fontaine des Marins, 26170 Plaisians, France 4/4

+33 (0) 4 75 28 29 35 www.urd.org

Registered training centre number 82 26 01542 26