European Program For

EPDET 2018

European Program for

Development Evaluation Training

Application form

Please fill in theApplication form and send it to organizers by e-mail:

by 31 March 2018 at the latest.

Name of participant:

Male Female Prefer not to say

Year of birth:

Contact address:

Contact phone:

E-mail: @

Organization of participant:

Country of residence:

Country of origin:

Tax identification number, if applicable:

Type of organization:

NGO: Government - Ministry: Private enterprise:

University: Government - Agency: Financial institution:

Consultant:Multilateral agency or program: Research institute:

Other (please specify):

Previous experience with development evaluation or management of development projects:

Yes:No:

How did you get information about EPDET?

Direct invitation from organizersRecommendation from EPDET graduates

Information via IPDET channelsInformation via IDEAS channels

DWW, SES or CES websitesOther (please specify):

Training and accommodation premises:

Hotel Duo, Teplická 492, 190 00 Prague 9, CzechRepublic

(

The hotel is easily accessible by public transport (stop Strizkov of Metro line C; 1 hour from VaclavHavelAirport; or 27 minutes by taxi), and very close to the centre of Prague (19minutes by Metro).

In case you wish to share your room with a concrete participant, please, fill in his/her name:

Special dietary requirements: vegetarian: other: allergies:

Participant fee:

The registration fee is 1840 EUR (equivalent of 46 000 CZK or 2230 USD). The fee includes five days accommodation in single rooms and full board, coffee breaks, and all tuition expenses including training materials for participants. International travel, taxi, visa costs and insurance are not included in the registration fee. The registration fee is not subject to VAT imposition.

For the participants having their own accommodation in Prague, the registration fee will be reduced to 1450 EUR (equivalent of 36 300 CZK or 1760 USD).

Early bird 15% discount (fee to be paid until 31 May 2018):

1600 EUR (equivalent of 40 000 CZK or 1940 USD) with accommodation

Or 1210 EUR (equivalent of 30 300 CZK or 1470 USD) without accommodation

Please, indicate whether you need accommodation or not:

I will stay in hotel Duo (I will pay fee 1840/1600 EUR)

I do not need accommodation (I will pay fee 1450/1210 EUR)

I will pay the registration fee in the currency: EUR CZK USD

The payment instructions will be sent to all registered applicants during April 2018.

After 15 July 2018, no refunds will be provided in case of participant cancellation, at the discretion of the management, substitutions may be possible. In such cases, contact the EPDET coordinator.

Invoice Information:

We require the following information to accept your application:

Name of person/organization paying EPDET fee in case it differs from the contact details of the participant:

Full address:

Tax identification/VAT number, if applicable:

Contact person to who invoice for fee is to be sent:

Telephone number (incl. prefix):Fax number (incl. prefix):

E-mail address:@

Thank you for registration!

Mr. Daniel Svoboda

Mobile phone: +420724179562, E-mail: , Skype: svoboda.dww