Train the Trainer Committee Member Application Form

1. APPLICANT PROFILE
1.1 Are you a graduate of the Train the Trainer Course (previously known as Teach the Teacher Course)? NOTE!! As a graduate the applicant should have either attended both the Part I (Online) and Part II (Face-to-Face) segments of the Train the Trainer course (the course re-launched version) OR the two training weeks of the Teach the Teachers course (the older course version).
1.2 Describe your experience in teaching, training, researching, publishing & reviewing in Anaesthesiology, Perioperative Medicine, Intensive Care Medicine, Critical Emergency Medicine and Pain management.
1.3 Describe your National and international teaching experience.
1.4 Do you have experience as a Faculty of the TTTC for the Week 1 and Week 2 of the course (based on previous course structure), or for the Online and F2F component (based on the current course structure)?
1.5 Upload your Curriculum Vitae (max. 2 A4 pages)

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2. ADDED-VALUE & VISION
What are your motivations for applying for this position? New perspectives, skills or approaches would you bring to this Committee that are not currently sufficiently represented? Please be specific and realistic.

Examples may include education or methodological innovation, interdisciplinary collaboration, diversity of viewpoints or geographical reach, educational or strategic development, etc.
(max. 2 A4 pages)

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3. CONTRIBUTION TO ESAIC & ENGAGEMENT
3.1 Current and Past contributions to ESAIC:
If you have not previously held a formal ESAIC role, please describe other contributions that demonstrate your engagement with another society and its mission.
List the roles you have or had in the Society
3.2 Availability and engagement:
Please confirm and briefly explain:
• Your ability to commit sufficient time and responsiveness to this role? 
• How you ensure continuity and follow-through alongside clinical duties?
• If you have parallel commitments in other ESAIC Committees and/or scientific societies

4. COLLABORATION & VALUES
4.1 Working within ESAIC values:
- ESAIC Code of Conduct
Describe how you ensure that your contributions align with the ESAIC Code of Conduct, particularly with regard to collaboration, managing conflicts of interest and inclusiveness
PLEASE DECLARE ANY CONFLICT OF INTEREST, i.e. relationship or arrangement with a commercial company, direct or indirect, that could be reasonably considered to affect the work in the committee.

This includes, but is not limited to, financial relationships, advisory positions, receipt of grants/research supports, receipt of honoraria or consultation fees, participation in a company sponsored speaker's bureau, stock shareholder, and spouse/partner financial relationships with a commercial company.
Please tick accordingly:
Receipt of grant/research support
Receipt of honoraria or consultation fee
Participation in a company sponsored speaker’s bureau
Stock shareholder
Other support (please specify)
Declaration
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Train the Trainer Committee