SEARCA TrAInS Application Form

APPLICATION FORM
Privacy and Consent to Use Data

SEAMEO SEARCA respects your privacy, and we are committed to treat your personal data with utmost fairness, responsibility, and security. Thus, personal information that you share with us are treated with uttermost care, integrity, and sensitivity. All personal details and photo/video/audio documentation related to your participation in this online training-workshop are managed by the Center for educational purposes. Such are gathered for use in Center-generated reports, documents, publications, and audio-video productions; for inclusion in databases of Center participants, partners, and stakeholders; and to send evaluation instruments and other post-training program documents as needed; and will not be transferred to any organization that does not have adequate data protection policies. SEARCA will keep your personal data not longer than six years after the fulfilment of the purposes set out in this notice and in accordance with the Center’s data privacy guidelines. By accomplishing and submitting this Application Form, you signify that you give consent to the collection and use of your personal information, as well as photo/video/audio documentation, for purposes stated above.
PERSONAL INFORMATION
Name*

PrefixFirst NameMiddle NameLast NameSuffix
Email Address*
example@example.com
Contact Number*

Country CodeArea CodePhone Number
Permanent Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Birth Date*

MonthDayYear
Date
Gender*
Nationality/Citizenship*
Religion
Civil Status

ORGANIZATIONAL AFFILIATION
Designation/Position/Title*
Office/Organization*
Office Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Office Telephone Number

Country CodeArea CodePhone Number
Number of years at present position*
Number of years at present organization*
Number of years of total working experience*
Name of current Manager/Supervisor and e-mail address*

PROFESSIONAL EXPERIENCE

Please provide details of up to three (3) previous organizational affiliations.
Position*
Organization*
Inclusive Dates (ex. 2015-2020)*
Position
Organization
Inclusive Dates (ex. 2015-2020)
Position
Organization
Inclusive Dates (ex. 2015-2020)

EDUCATIONAL BACKGROUND

Please provide details of up to three (3) previous educational attainment.
Degree Obtained*
(please indicate fields/areas of specialization)
Institution/University*
Location*
Award Date*
Degree Obtained
(please indicate fields/areas of specialization)
Institution/University
Location
Award Date
Degree Obtained
(please indicate fields/areas of specialization)
Institution/University
Location
Award Date

I hereby confirm that I have coordinated with my Supervisor/Employer that I can dedicate the time necessary to participate in all the sessions of this online training workshop and that I will actively engage with fellow participants.
Please upload your accomplished and fully signed Statement of Commitment here.*

Cancelof
Signature of Participant*
Name of Participant*
Date of Signature*

MonthDayYear
Date
Thank you!

Please accomplish this form not later than 15 October 2022. For any questions and/or clarifications, you may reach out to Ms. Rosario B. Bantayan, Program Specialist, Education and Collective Learning Department-Training for Development Unit (ECLD-T4DU) of SEARCA through email at rbb@searca.org and cc. training@searca.org.
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Agriculture and Development
Agricultural Innovation Systems
Agriculture in the 4th Industrial Revolution
Governance Framework for Innovation Systems
Agricultural Graduates and Engaging the Youth for the New Future
The Future of Agriculture and Futures Thinking

APPLICATION FORM

Privacy and Consent to Use Data

PERSONAL INFORMATION

ORGANIZATIONAL AFFILIATION

PROFESSIONAL EXPERIENCE

EDUCATIONAL BACKGROUND

KNOWLEDGE AND SKILLS

Thank you!