Earth Charter Center for Education for Sustainable

Development
International Law, Global Governance and the Earth
Charter principles
Course Application
First name*
Last name*
Date of Birth* dd/mm/yyyy
Nationality*
Passport or ID number*
Sex m/f*
Address
Zip ode
!ountry of residene
"r#ani$ation/ompany*
%itle*
Profession*
&mail address*
Phone*
'obile phone
Fax
Short bio* (&duation ba)#round * Bahelor+ 'aster+ Dotor in ,hih -eld.
"/er/ie, of your professional experiene0
1ele/ane of ourse to 2ob/profession
3hat do you hope to #et out of this ourse.*
Do you ha/e any disabilities+ medial onditions+ or dietary restritions.*
Is there anythin# else that ,e should )no, if you attend this ourse in !osta 1ia.
&mer#eny ontat details+ name+ email+ phone*
4o, did you hear about this ourse.
Fields mar)ed ,ith * are mandatory
Please sa/e this doument as -rst initial last name &! appliation (5ane Smith 6
5Smith &! appliation7do0 and send it to apply8earthharter7or#