CODATU TRAINING PROGRAMME Course C7 2017

“CODATU TRAINING PROGRAMME “Course C7 2017” (CODATU-TPC7-17), Hyderabad, India, 7 to 9 Nov, 2017 “Topics of Concern to Young Transport Professionals / Researchers in Developing Countries”

Application Form

1. Please read carefully, complete and sign; send in pdf to: CODATU Secretariat

“Chantal Picard”

2. Deadline of Application: 30 September, 2017

3. Incomplete files will not be considered

Name of Applicant: First: Middle: Recent Photo Family: ...... Date of Birth: dd/mm/yyyy

Age in Nov 2017 (Years):

Gender: Female/Male

Permanent Address:

City: ...... Country:...... Zip: e-mail: Mobile Phone: . Current Status: Position:

Employer: ...... Address: . . . City: Country: ...... Zip: . . . . Phone:...... Graduation Info: - Degree (BSc, BA, …): - Field: - Civil Engineering ( ) - Mechanical Engineering ( ) - Electrical Engineering ( ) - Economics ( ) - Informatics ( ) - Logistics ( ) - Social Science ( ) - Others (please specify):

- Faculty: - University: - Country: - Date: mm/yyyy

Registration Conditions: - Attendees should be less than 30 years old by November 2017. - Attendees should be formally registered for attending CODATU-XVII and UMI- 10 Conference, Hyderabad, India, 4 to 6 November, 2017. - No registration or tuition fees are required. - However, CODATU does not bear any cost or responsibility of accommodation, transport, meals, insurance, etc., for the attendees. - An official CODATU Certificate of Attendance will be handed to each participant attending (in full) a minimum of 13 out of the 14 Lectures of the course. - Attendance sheet of each lecture should be signed during the first 5 min of the lecture - The maximum number of attendees is 35 persons. - Registration will be on “first arrived first served” bases. - If the maximum number of attendees is reached before the deadline, registration will cease.

Applicant Declaration: I, the undersigned, declare that the information given in this Application Form are correct, and that I have read, understood and fully accept the rules and conditions of the CODATU Training Course, 7 to 9 Nov 2016, Hyderabad, India. Name: Date: dd/mm/yyyy City:

Signature: