16.11.2013 Views

International Consultants' Training Course - GHDonline

International Consultants' Training Course - GHDonline

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In order to select the most eligible candidates for this course, may we kindly ask you to fill<br />

in the below Short professional profile form:<br />

Name (First name and Family name)<br />

Sex<br />

Current position<br />

(indicate your affiliation and responsibility, e.g.<br />

NTP officer, HIV/AIDS program officer, Nursing<br />

section, occupational health, etc.)<br />

Professional background (Medical doctor, nurse,<br />

engineer, health officer, etc.…)<br />

What are your current tasks and<br />

responsibilities in the field of infection<br />

control?<br />

Have you ever before participated in training on<br />

non-TB related infection control?<br />

Have you ever received training on TB Infection<br />

Control? If so, when and by whom?<br />

Yes/No<br />

Yes/No, …<br />

Have you been conducting consultancy missions<br />

in the past, if yes since when, in which fields and<br />

to which countries/regions<br />

Name and contact details of your<br />

supervisor/coordinator<br />

What are your expectations of the course?<br />

Will you be able to commit to 2-4 TB-IC related<br />

missions per year? If so to which<br />

countries/region(s)<br />

26

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