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Complete the whole form. Fields marked with * are mandatory;
Click "Submit application" at the end of the form. Save the generated PDF and send the form to your National Training Coordinator for approval;
Your National Training Coordinator will evaluate and forward the application (approval) to the Programme Team for processing.
Contact details of your National Training Coordinator can be found under Participating States.
First name (as appears in passport) *
Last name (as appears in passport) *
Date of birth (dd/mm/yyyy) *
Nationality * ... Albania Algeria Armenia Austria Azerbaijan Belarus Belgium Bosnia and Herzegovina Bulgaria Croatia Cyprus Czech Republic Denmark Egypt Estonia FYROM Finland France Georgia Germany Greece Hungary Iceland Ireland Israel Italy Jordan Kosovo Latvia Lebanon Libya Lithuania Luxembourg Malta Moldova Montenegro Morocco Netherlands Norway Palestine Poland Portugal Romania Serbia Slovak Republic Slovenia Spain Sweden Tunisia Turkey Ukraine United Kingdom
Country of Residence * ... Albania Algeria Armenia Austria Azerbaijan Belarus Belgium Bosnia and Herzegovina Bulgaria Croatia Cyprus Czech Republic Denmark Egypt Estonia FYROM Finland France Georgia Germany Greece Hungary Iceland Ireland Israel Italy Jordan Kosovo Latvia Lebanon Libya Lithuania Luxembourg Malta Moldova Montenegro Morocco Netherlands Norway Palestine Poland Portugal Romania Serbia Slovak Republic Slovenia Spain Sweden Tunisia Turkey Ukraine United Kingdom
Gender * Female Male
Email *
Mobile *
Your profession or job title *
Address Workplace / Volunteer Organisation * Workplace Volunteer Organisation
Institution/Organisation *
Street and Number *
City and Postcode *
Telephone *
Name of Supervisor / Superior
Supervisor contact Email *
Motivation for applying
Use this section to give a clear idea of your interest and motivation for the exchange.
State the main focus of the exchange *
State the results and benefits you anticipate *
Give reasons for choosing a specific country or organisation *
Indicate specific benefits this exchange will have for your host organisation *
Expert’s field of expertise (select all that apply)
CBRNOperations centrePreparednessPreventionRisk AssessmentCoordination and Incident ManagementCoordination of TrainingEmergency Calls ManagementEx-post disaster assessmentFire investigation and PreviewFire serviceGIS SystemsNatech disasterPsychological AftercareRelief OperationsResponse SystemRisk MappingRisk PreventionSearch and RescueSeveso installationsTechnical Expertise
Position
Assessment ExpertCoordinator or Coordinating Team MemberDeputy Intervention Team LeaderIntervention Team LeaderKey National Contact Point StaffLiaison OfficerRegistered In CECISStaff involved in policy making on disaster managementStaff responsible for handling and receiving emergency callsTechnical Expert
Training Course Participation
AMC Assessment Mission Course CMI / UCPM Introduction Course CND Course on Negotiation and Decision-making HLC High Level Coordination Course HLCR HLC Refresher Course HOT Head of Team Course ICC International Coordination Course IMC Information Management Course MBC Modules Basic Course MSC Media Security Strategy Course OPM Operational Management Course OPMR OPM Refresher Course SEC Security Course SMC Staff Management Course SME Seminar for Mechanism Experts TEC MI Technical Experts Course for Maritime Incidents TEC Technical Experts Course
Language *
Indicate your foreign language skills by selecting the appropriate classification from the dropdown menus.
Understanding * ... basic proficient fluent
Speaking * ... basic proficient fluent
Writing * ... basic proficient fluent
Language (specify):
Understanding ... basic proficient fluent
Speaking ... basic proficient fluent
Writing ... basic proficient fluent
Host details: Please provide country, organisation and contact details if known
Host details (Contact person, telephone, email etc.)
Time period for the exchange (date and duration) *
Is this a Group Exchange? (Yes / No / Number of experts / Please note that every expert has to fill in an application form)
Name(s) of back-up person (In the event of a medical or professional emergency preventing you from participating in the exchange, name the person who will take your place) *
I have read the Guidelines and hereby agree with the conditions of the Exchange of Experts Programme.
Click to confirm (as per signature)
© Exchange of Experts - 2015