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Training Course on NDC Capacity Building:

Access and Analysis of Radionuclide IMS Data and IDC Products

from 3 to 14 July 2017

Vienna, Austria

ELIGIBILITY CRITERIA AND PARTICIPANT PROFILE

1.  What best describes your role in your home institution (mark all that apply)?

NDC staff Waveform analyst Radionuclide analyst

Station operator Other, specify______

2.  Are you an authorized user of IMS data and IDC products?

No Yes, Principal User Yes, Regular User My SSO account* is ______

* SSO account is the username for accessing the IDC Secure Web Portal (swp.ctbto.org)

3.  Have you successfully completed E-Learning Training Course on NDC Capacity Building: Access and Application of IMS Data and IDC Products?*

No Yes, my username is______

4.  Have you successfully completed the Two-Week Waveform Analyst Training Course?*

No Yes, I attended the course on the following date ______

* Passing NDC Analysts e-Learning Course or the Two-Week Training Course is a prerequisite when applying for the 1-month course and is considered in the selection process.

REGISTRATION FORM

Please fill out the form electronically. If you use pen, please write legibly in block. Name should be written as it appears in your PASSPORT!

Ms. Mr.

FAMILY NAME FIRST NAME (S)

NATIONALITY / DATE OF BIRTH (DD/MM/YY) / PLACE OF BIRTH
PASSPORT No / ISSUING DATE / EXP. DATE / DEPARTURE CITY
MOBILE (INCL. INT CODE) / WORK PHONE / EMAIL

CONTACT PERSON IN CASE OF EMERGENCY (NAME, ADDRESS, PHONE)

KNOWLEDGE OF LANGUAGES. What is your mother tongue?

Read / Write / Speak / Understand
OTHER LANGUAGES / Easily / Not easily / Easily / Not easily / Fluently / Not fluently / Easily / Not easily
ENGLISH / / / / / / / /

CURRENT EMPLOYMENT:

From (month/year) / To (month/year) / Exact title of your post
Name, address and phone number of the employer / Type of business
BRIEF DESCRIPTION OF YOUR DUTIES

EDUCATION and TRAINING

A. University or equivalent
Name, place and country / Years attended / Degrees and academic distinctions / Main course of study
from / To
B. Relevant professional training
Name, place and country / Type / Years attended / Certificates or diplomas obtained
From / to

CTBTO Science and Technology Conference SnT2017

SPECIAL OPPORTUNITY:
The CTBT: Science and Technology 2017 Conference (SnT2017) will take place from 26 to 30 June 2017 at the Hofburg Palace in Vienna, Austria. It will be the sixth in a series of multidisciplinary conferences designed to further enhance the strong relationship between the scientific and technological community and the CTBTO. See the complete information here: àSnT2017
Applicants to this training course have the opportunity to request participation with funding to the SnT2017 Conference of the CTBTO. However, in order to be considered for participation in the conference, the applicants must register to the conference (https:/ctnw.ctbt.org) and submit an abstract that the Scientific Committee considers a contribution to the CTBTO. Instructions on abstract submission can be found in the links above.

I would like to request participation in the SnT2017

Yes No
DIRECTOR OF INSTITUTION CANDIDATE

(Name, date, signature) (Date, signature)

...... / ......

This Registration Form must be returned through the appropriate country’s Permanent Mission in Vienna or Ministry of Foreign Affairs by latest 18 April 2017, in order for a candidate to be considered for the programme. Please send to:

Ms. Johanna Fessl
IDC/CBT, CTBTO
P.O. Box 1200

A-1400 Vienna, Austria
Email:
Phone: +43 1 26030 6484
Fax: +43 1 26030 5973

However, pending its official transmission, the filled Registration Form should be sent by email in order not to delay the preparation by CTBTO for the candidate’s participation.

Each participant is responsible for obtaining his/her own visa to AUSTRIA, upon receipt of an official Acceptance Note Verbale from the Provisional Technical Secretariat.