EVENT TOT Trg. DPU Application doc by pn641q


									                                Training Institute for Technical Instruction (TITI)
                   Application for Professional Training of Trainers (ToT)
     (Based on tripartite agreement between CTEVT, EVENT Project of the World Bank and TITI)
   1. The training course that you are applying for: (Select only one course and batch that you are applying for).
      Name of the       Batch          Place and Date              Put a tick mark                     Remarks
       Training                 (Dates will be as indicated in the in 1 place only
                                                    call for application)
   Master Trainer               I           TITI, Sanothimi
                                II          TITI, Sanothimi
   Lead Trainer                 I           TITI, Sanothimi
                                II          Dharan
                                III         Butawal
                                IV          Dhangadi
   Assistant Trainer            I           TITI, Sanothimi
                                II          Dhangadi
                                III         Dharan
                                IV          Butwal

   2. Please Give Your Personal Details:
  Full Name ( in
  Block Letters)
Address (Permanent) Zone              District                                      VDC,                          Ward No
 Address (Mailing)           Zone                     District                      VDC,                          Ward No
E mail                                   Mobile No                                               Landline Phone
Date of                       Sex          Mother’s or
                                            M                                                    Nationality
 Birth                                   Father’s Name
                                           and address
   3.     Give Details of your Educational Background:

     Name of                                  Name of University or Board                         Year of             Division
  Degree/Diploma                                                                                 Completion

    4. Your Work Experience:
   Name of the organization  Post / position                            From             To               Major responsibility

   5.     Provide Information about Your Employment Status: Self Employed …Wage Employed… Unemployed…
          (If wage employed or self employed, fill in the following table)
 Name of your organization                 Business area            Duration of         Regd.             Your responsibility
                                                                    experience        No/PAN No

   6. Provide Details of your Training and Professional Development Activities and Experiences:
Name and Duration of the training       Providing organization                 Training Place and Date

    7. Provide Information about your Language Proficiency (Nepali, English, Others----------,-------, )
Rate your ability from Low (1) to High (6 )
       1                   2                3              4                  5                     6

     8.    Indicate your Areas of Practical Expertise in Technical Education and Vocational Training
(Mention at least two occupational areas that you can contribute most as a trainer/instructor, e.g. plumbing, carpentry,
electrician, hospitality industry, IT, general mechanics, mobile repair, auto-mechanic, nursing etc….. )
1                                                      2
3                                                      4
   9. Specify your Computer Skills (Write only if you have full competency)
(What can you do using computers?)
1                                    2                                     3
4                                    5                                     6
   10. Write 5 lines (150 words) stating your motivation and abilities to be a Professional Trainer:

     11. Indicate your ‘Personal Declaration’
I hereby declare that all the information I presented in this          Name of the Candidate:
form are true and correct. I accept penalty in case lack of
evidence whenever asked for verification.
                                                                       Signature and Date:

     12.   For official use only (Candidates do not need to fill up this part). Appl. Regd. Code:------------------
Form Accepted / Not Accepted                           Name:                                        Signature:

Interview/Selection committee decision                 Candidate Selected: Yes              No      Date:


To top