Application Form

APPLICATION FORM

Full Name

Date of Birth

Place of Birth

Nationality

SEX

Male Female

Address

Address line 2

City

State/Province

ZIP/Postcode

Country

Phone Number

Mobile

Fax

Profession

Currect Employer

Education

Work Experience

English

* = required

Annulment: Written annulment is compulsory. In case of annulment the following costs will be charged:

• Up to three months before the course starts, the course fee will be refunded minus administration costs of Euro 50,00

• up to one month before the course starts 25% of the course fee will be charged

• up to 14 days before the course starts and in case of premature termination the total course fee will be charged

Important Info

Select course

01 CBR Introduction Course
02 Management and Leadership in cbr
03 Training of Trainers (TOT) in cbr
04 Training Disability - HIV/AIDS

Please make sure all the required field are filled in before submitting your application. Thank You






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Enablement		address	Contact
Internet: E-mail: Skype:	www.enablement.nl h.cornielje@enablement.nl enablement	A van Leeuwenhoekweg 38 Unit A16 Lions Gate 2408 AN Alphen aan den Rijn The Netherlands	Phone: Fax: Mobile:	+31-172-499940 +31-172-244976 +31-6-28485083