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extensio et progressio / authentic e-learning

e-Pharmaceutical Cold Chain Management Course

Introduction
Video Learning
Objectives Programme
Document
Library Video
Library

EPELA/WHO on-line application for
Pharmaceutical cold chain management e-learning programme

Personal information

Family name:

Name:

Password:

Title:

Gender:

Nationality:

Date of birth:

Institution details

Institution name:

Full professional mailing address:

City:

Postal code:

Country:

Type of instutition:

Contact details

Tel:

Fax:

Mobile:

E-mail:

Skype:

Job title:

Since when are you holding this position:

Description of duties:

Academic background (Start with the most recent one):

Name of school/institution	Degree or diploma earned	Years of attendance
Name of school/institution	Degree or diploma earned	From	To

Professional background

List the previous positions held (NOT your current position)

Name of institution	Positions held	Years of employment		Brief description of duties
Name of institution	Positions held	From	To	Brief description of duties

Participation in learning events

Have you ever participated in WHO Global Learning Opportunity training courses?

Yes No

Have you ever participated in other training courses delivered by other organizations related to vaccine quality?

Yes No

Supervisory / institutional approval

I confirm that I have discussed with my supervisor(s) and have my institute's endorsement for my on-line application

Required attachments

Curriculum vitae or resume (Word or pdf):

Proof of language proficiency (Word or pdf):

Photograph (jpg):

Course fee (Industry and private sector applicants only)

I understand that if accepted, I agree to pay USD 3,500 as the course fee.

About me

Describe yourself briefly here. If you are accepted, this information will be shared with other participants.

Title of the course	Delivered by (organization)	Location (Country)	Year attended

EPELA/WHO on-line application for Pharmaceutical cold chain management e-learning programme