Workshop on Water and Sanitation

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					                                                                                 This project is co-funded by
                                                                                     the European Union




                                            Application Form

    Workshop on Water and Sanitation, 25th and 26th November 2009,
                 Training Center of the Polish Red Cross in Zgierz, Poland
Thank you for your interest in participating in the WatSan workshop. Please fill out this application form and send
it before 25th October to: juerg.graf@redcross.at
The capacity of the workshop is limited to 25 places. Should the demand exceed the capacities, we might not be
able to accept all applicants. We will inform you if your application has been successful after 25th October. Please
notice that accommodation and catering from 24th – 27th November 2009 (three nights) at the Training Center of
the Polish Red Cross in Zgierz, Poland, are covered by the Austrian Red Cross. Any additional hotel costs will not
be covered.
Please notice that participants are responsible for making their own travel arrangements. The Austrian Red Cross
can not cover travel expenses. However, for international participants a pickup/transport service might be
organized on the following dates: 24th November from Warsaw to Zgierz, 27th November from Zgierz to
Warsaw.

Applicant
First name:
Family name:
Sex:
Date of birth:
Nationality:
Email:
Phone number:

Deploying organization
Name of organization:
Main activity of organization:
Department/Section:
Address:
Web-page:
Email and phone number of organization:
Your position in organization:

Knowledge/Experience
Is your organization involved in humanitarian and relief work? If yes, please specify in what way:

Do you personally have already knowledge/experience in the field of water and sanitation? If yes, please describe
in few words in what way:

Do you personally have knowledge/experience with disaster relief or development project in developing
countries? If yes, please describe in few words in what way:

Please describe in few words your motivation for a workshop participation:

Thank you! If you have any question, contact Mr. Jürg Graf, Austrian Red Cross, juerg.graf@redcross.at

				
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posted:11/6/2012
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