ࡱ>  0bjbj]W]W 8?=?= R R 8lhT?N,>>>>>>>$ AC>>>---F>->--RF:<0N]:;~>>0?X;ADAD<<AD<->>y?ADR $ v: IOC-UNESCO Intergovernmental Coordination Group for the Indian Ocean Tsunami Warning and Mitigation System (ICG/IOTWMS) Regional Workshop on Post-IOWave14 Exercise Assessment and Standard Operating Procedures for Tsunami Warning and Emergency Response for Indian Ocean Countries INCOIS, Hyderabad, India, 6-10 November 2015 APPLICATION FORM Deadline for applications: 9th October 2015. Successful applicants will be contacted by 16th October 2015. Applications should be sent to the ICG/IOTWMS Secretariat by email to:  HYPERLINK "mailto:iotws@unesco.org" iotws@unesco.org. Please indicate: Do you wish to apply for travel, accommodation and subsistence support?*  FORMCHECKBOX  Does your country intend to participate to community level in Exercise IOWave16, scheduled to take place in September 2016?  FORMCHECKBOX  Please refer to the announcement letter for eligibility criteria for travel, accommodation and subsistence support. *Priority for funding support will be given to countries that have indicated their intention to conduct Exercise IOWave16 to community level. Are you a middle to senior National Tsunami Warning Centre (NTWC)  FORMCHECKBOX  manager or operator? Or Are you a middle to senior National Disaster Management Office  FORMCHECKBOX  (NDMO) manager or operator? Or Are you a middle to senior Local Disaster Management Office  FORMCHECKBOX  (LDMO) manager or operator? PERSONAL INFORMATION FULL NAME (as per passport)TITLE FORMCHECKBOX  DR.  FORMCHECKBOX  MR.  FORMCHECKBOX  MS.  FORMCHECKBOX  others _________GENDER FORMCHECKBOX  MALE  FORMCHECKBOX  FEMALEDATE OF BIRTH (DD-MM-YYYY) NATIONALITY ORGANISATION AND POSITIONADDRESS  TELEPHONE NUMBERFAX NUMBER  EMAIL ADDRESS   EDUCATIONAL BACKGROUND LEVELSCHOOLDEGREEYEAR GRADUATEDTERTIARY    MASTERS DOCTORAL  3. TSUNAMI RELATED TRAININGS ATTENDED TITLE OR SUBJECTCONDUCTED BYINCLUSIVE DATES        OTHER TSUNAMI-RELATED JOB EXPERIENCE OFFICE / ORGANIZATION JOB DESCRIPTIONPOSITIONDATES         5. TRAVEL INFORMATION FULL NAME (AS PRINTED ON PASSPORT)DATE OF BIRTH (DD-MM-YYYY)PASSPORT ISSUING COUNTRYPASSPORT NUMBERDATE OF ISSUE  PLACE OF ISSUE  EXPIRY DATE  NEAREST INTERNATIONAL AIRPORT  OTHER ENGLISH LANGUAGE PROFICIENCY  FORMCHECKBOX  Excellent  FORMCHECKBOX  Good  FORMCHECKBOX  Fair  FORMCHECKBOX  Poor DO YOU REQUIRE TRAVEL FUNDING? FORMCHECKBOX  Yes, Full Funding  FORMCHECKBOX  Yes, Partial Funding, Amount USD ____.  FORMCHECKBOX  No, Self-funded  STATEMENT OF INTEREST: Why are you interested in attending this Training? Please explain your motivation. After the Training, where and how will the experience gained in the Training will be used? Please also submit separately your Curriculum Vitae (CV). ________________________________________________ PRINTED NAME AND SIGNATURE OF APPLICANT DATE: _________________ ENDORSEMENT OF TSUNAMI NATIONAL CONTACT (TNC): Printed Name (TNC) Signature Organization DATE     Annexed to IOC Circular Letter, 2596 All Correspondence To: Head , ICG/IOTWMS Secretariat, IOC Perth Office, PO Box 1370 West Perth, WA 6872 AUSTRALIA, Email: iotws@unesco.org Tel: +61 (08) 9226 0191 Fax: + 61 (08) 9263 2261 All Correspondence To: Head , ICG/IOTWS Secretariat, IOC Perth Office, PO Box 1370 West Perth, WA 6872 AUSTRALIA, Email: iotws@unesco.org Tel: +61 (08) 9226 0191 Fax: + 61 (08) 9226 0599  tux    ( * / 1 5 6 > B C D ۷o]o]o]K]K]K]#hemh@CJOJQJ\^JaJ#hemh_SCJOJQJ\^JaJ#hemh_CJOJQJ\^JaJ#hemh15CJOJQJ^JaJ#hemhTs5CJOJQJ^JaJ#hemhQ45CJOJQJ^JaJ#hemh_S5CJOJQJ^JaJ#hemh@OJQJ\^JmH sH #hemhp/OJQJ\^JmH sH #hemh_S5OJQJ^JmH sH  x D U C T U  G K L r $x]a$gd1 ]^gdQ]^`gdQx]^`gd1gd8(xgdQ "( Px 4 #\'*.25@9gdr xxgdQ $a$gd_S$Kxx`Ka$gd $a$gdp/ D U n p q s t { ~  ǰjS>))hemh@0JB*OJQJ^JaJph)hemhp/0JB*OJQJ^JaJph,hemh_S0J5B*OJQJ^JaJph,hemhp/0J5B*OJQJ^JaJph,hemh@0J5B*OJQJ^JaJph/hemh 0J5B*H*OJQJ^JaJph,hemh 0J5B*OJQJ^JaJph)hemhZ 0JB*OJQJ^JaJph)hemh8(0JB*OJQJ^JaJphhemhZ OJQJ^JaJ    . / ? @ B ԿԀfQf;f+hemh_0J>*CJOJPJQJ^JaJ)hemh_0JB*OJQJ^JaJph2jhemh_0JB*OJQJU^JaJph)hemh 0JB*OJQJ^JaJph)hemh|?0JB*OJQJ^JaJph)hemh_S0JB*OJQJ^JaJph)hemh@0JB*OJQJ^JaJph)hemh10JB*OJQJ^JaJph,hemhb0JB*H*OJQJ^JaJphB C S T U   . 0 4 5 6 D ʶwj]j]Oj]j>j!jhemhMyOJQJU^JhemhQ4OJQJ\^JhemhQ4OJQJ^JhemhMyOJQJ^J'jhemh1OJQJU^J!jhemh1OJQJU^Jhemh_OJQJ^Jhemh1OJQJ^J&hemhMy5>*CJOJQJ^JaJhemhMy5>*OJQJ^Jhemhl5>*OJQJ^J)hemhZ 0JB*OJQJ^JaJphD E F G , 5 I J K L S T Ϳ~~m_NA4hemh_SOJQJ^JhemhlOJQJ^J hemh1CJOJQJ^JaJhemhaQOJQJ\^J!hemhaQ5>*OJQJ\^J!hemh15>*OJQJ\^J!hemhQ45>*OJQJ\^J!hemhX5>*OJQJ\^Jhemh_OJQJ\^Jhemh1OJQJ\^JhemhMyOJQJ^J!jhemhMyOJQJU^J'jvhemhMyOJQJU^JT V h p q x y ijğ}oaP hemh@OJQJ^JmH sH hemhl>*OJQJ^JhemhF5OJQJ^JhemhlOJQJ^J)jhemh-OJQJU^JmH sH 'jhemh-OJQJU^J!jhemh-OJQJU^Jhemh-OJQJ^J hemh-OJQJ^JmH sH  hemh_SOJQJ^JmH sH hemh'UOJQJ^JL  * - ~ {rrr $Ifgd|n & F x^`gd@h]^`hgd1h]^`hgdMy & F]gd1x]^gd x]^`gd1h]^`hgd- & F]gd-   ( * - 7 H b k l m { | ކxkZIk5'jhemh1OJQJU^J!jhemh1OJQJU^J hemh1OJQJ^JmH sH hemh1OJQJ^Jhemh1>*OJQJ^J hemh@OJQJ^JmH sH )jhemh-OJQJU^JmH sH 'jbhemh-OJQJU^Jhemh-OJQJ^J!jhemh-OJQJU^J hemh-OJQJ^JmH sH  hemhQ4OJQJ^JmH sH | } ~  ȷȪ|kVk>VkVk/jhemh@CJOJQJU^JaJ)jhemh@CJOJQJU^JaJ hemh@CJOJQJ^JaJhemh@5OJQJ\^J hemh@CJOJQJ^JaJhemh@OJQJ^Jhemh1OJQJ^J hemhQ4OJQJ^JmH sH  hemh@OJQJ^JmH sH  hemh1OJQJ^JmH sH )jhemh1OJQJU^JmH sH  D|| <<$Ifgd|nvkdN$$Ifl0p#0#64 layt|n !"012LM[\]ghvwx  yaP hemh@CJOJQJ^JaJ/jhemh@CJOJQJU^JaJ/j@hemh@CJOJQJU^JaJ/j;hemh@CJOJQJU^JaJ/jhemh@CJOJQJU^JaJ hemh@CJOJQJ^JaJ)jhemh@CJOJQJU^JaJ/jShemh@CJOJQJU^JaJDEL|| <<$Ifgd|nvkd$$Ifl0p#0#64 layt|n $Ifgd|nvkd($$Ifl0p#0#64 layt|n $Ifgd|nvkd$$Ifl0p#0#64 layt|n $Ifgd|nvkdJ$$Ifl0p#0#64 layt|n $Ifgd|nvkd$$Ifl0p#0#64 layt|n $Ifgd|nvkdl$$Ifl0p#0#64 layt|n $Ifgd|nvkd$$Ifl0p#0#64 layt|n  $Ifgd|nvkd $$Ifl0p#0#64 layt|n    #)07Fkbbbb $Ifgd|n & F xx^`gd@gd@vkd $$Ifl0p#0#64 layt|n  #stu EKLPQUVZ[_`abx>?@߾߱Π~pccUppUhemh 5OJQJ^JhemhQ4OJQJ^Jhemh@5OJQJ^J hemh CJOJQJ^JaJ hemh@CJOJQJ^JaJ hemhQ4CJOJQJ^JaJhemh@OJQJ^Jhemh 5OJQJ\^J hemh@CJOJQJ^JaJhemh@5OJQJ\^J hemhQ4CJOJQJ^JaJFGPQR2''' <$Ifgd|nkd $$Ifl\x(#   (0#64 lap(yt|nRSTUVWX`abcXkd $$Ifl\x(#  0#64 layt|n <$Ifgd|n cdenopqrXkde $$Ifl\x(#  0#64 layt|n <$Ifgd|nrstuc\\MDDD $Ifgd|nx^`gd@xgd@kd $$Ifl\x(#  0#64 layt|nULLLLLL $Ifgd|nkd $$IflF "   06    4 lapyt|n{rrrr $Ifgd|nkd$$IflF "   06    4 layt|n{rrrr $Ifgd|nkd&$$IflF "   06    4 layt|n{rrrr $Ifgd|nkd$$IflF "   06    4 layt|n{rrrr $Ifgd|nkdH$$IflF "   06    4 layt|n $4=CD{vvfv]]]]] $Ifgd|n & F 7^7`gd@gd@kd$$IflF "   06    4 layt|n DEFGHIJKNEEEEEE $Ifgd|nkdj$$IflF"L p 06    44 lapyt|nKLMNOPtkkkk $Ifgd|nkd@$$IflF"L p06    44 layt|nPQRSTUtkkkk $Ifgd|nkd$$IflF"L p06    44 layt|nUVWXYZtkkkk $Ifgd|nkdV$$IflF"L p06    44 layt|nZ[\]^_tkkkk $Ifgd|nkd$$IflF"L p06    44 layt|n_`axytgZUJJ <$Ifgd|ngd@ ^`gd@  !@h`hgd@kdl$$IflF"L p06    44 layt|n~~~ <$Ifgd|nvkd$$Ifl0n"064 layt|n~~ <$Ifgd|nvkd$$Ifl0n"064 layt|n~~ <$Ifgd|nvkd $$Ifl0n"064 layt|n~~~~ <$Ifgd|nvkd$$Ifl0n"064 layt|n    ~~~~ <$Ifgd|nvkd#$$Ifl0n"064 layt|n  ~~~~ <$Ifgd|nvkd$$Ifl0n"064 layt|n;<=~~~ <$Ifgd|nvkd9$$Ifl0n"064 layt|n=>?@FGqr&tk^UU $Ifgd|n $If]gd|nh^hgd@ & F 7^7`gd gd@vkd$$Ifl0n"064 layt|n@Frs '(GHVWXlm{r^'jhemh@OJQJU^J hemh@CJOJQJ^JaJ'jhemh@OJQJU^J'j7hemh@OJQJU^J'jhemh@OJQJU^J'jOhemh@OJQJU^J!jhemh@OJQJU^Jhemh@OJQJ^Jhemh@0JOJQJ^J&'(Gl $Ifgd|nh^hgd@gkd#$$Ifl"O#0O#644 layt|n{|}9@E :GHagik͹͎ͫ́qaqQqhemh75OJQJ\^Jhemh@>*OJQJ\^Jhemh@5OJQJ\^Jhemh7OJQJ^Jhemh@5OJQJ^Jhemh@0JOJQJ^Jhemh75OJQJ^J'jhemh@OJQJU^Jhemh@OJQJ^J!jhemh@OJQJU^J'j hemh@OJQJU^J:;<=>qaSSSSSSL@&]^Lgd@ & F ^`gdQ & F 7@&]^7`gd@xkd$$Ifl0"(l0644 layt|n >?@ABCDEF r]^rgd@L@&]^Lgd@HIJghijklmnr&d@&P^rgd@ & F @&^`gdQ r@&^rgd@r^rgd@ r]^rgd@/0û}yhizhBhn#B* CJph-xhQ4B* CJph-xhB* CJph-x.hemh,6CJOJQJ]^JaJmH sH hemjhemUhemh@OJQJ^J$hemh@OJPJQJ^JnHtHhemh7OJQJ\^Jhemh@OJQJ\^J}$a$gd$a$gd,rx]^rgd@r&d@&P^rgd@ r@&^rgd@ @ r@&^rgd@;Srx]^rgd@gd$a$gd6&P 1h:p. A!V"#n$n% vDeCheck10vDeCheck10vDeCheck10vDeCheck10vDeCheck10$$If!vh#v#v:V l0#6,554yt|ntDeCheck1tDeCheck2tDeCheck4tDeCheck5$$If!vh#v#v:V l0#6,554yt|ntDeCheck2tDeCheck7$$If!vh#v#v:V l0#6,554yt|n$$If!vh#v#v:V l0#6,554yt|n$$If!vh#v#v:V l0#6,554yt|n$$If!vh#v#v:V l0#6,554yt|n$$If!vh#v#v:V l0#6,554yt|n$$If!vh#v#v:V l0#6,554yt|n$$If!vh#v#v:V l0#6,554yt|n$$If!vh#v#v:V l0#6,554yt|n $$If!vh#v#v #v #v:V l (0#6,55 5 54p(yt|n$$If!vh#v#v #v #v:V l0#655 5 54yt|n$$If!vh#v#v #v #v:V l0#655 5 54yt|n$$If!vh#v#v #v #v:V l0#655 5 54yt|n$$If!vh#vx #v{ #vr :V l 06,5 5 4pyt|n$$If!vh#vx #v{ #vr :V l065 5 4yt|n$$If!vh#vx #v{ #vr :V l065 5 4yt|n$$If!vh#vx #v{ #vr :V l065 5 4yt|n$$If!vh#vx #v{ #vr :V l065 5 4yt|n$$If!vh#vx #v{ #vr :V l065 5 4yt|n$$If!vh#v4#v #ve:V l 065L5 5ppyt|n$$If!vh#v4#v #ve:V l065L5 5pyt|n$$If!vh#v4#v #ve:V l065L5 5pyt|n$$If!vh#v4#v #ve:V l065L5 5pyt|n$$If!vh#v4#v #ve:V l065L5 5pyt|n$$If!vh#v4#v #ve:V l065L5 5pyt|n$$If!vh#v#v:V l06554yt|n$$If!vh#v#v:V l06554yt|n$$If!vh#v#v:V l06554yt|n$$If!vh#v#v:V l06554yt|n$$If!vh#v#v:V l06554yt|n$$If!vh#v#v:V l06554yt|n$$If!vh#v#v:V l06554yt|n$$If!vh#v#v:V l06554yt|ntDeCheck8tDeCheck8vDeCheck10vDeCheck11r$$If!vh#vO#:V l0O#65O#yt|ntDeCheck8tDeCheck8hDe{$$If!vh#v##vB:V l065(5lyt|nb 2 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~^J_HmH nH sH tH @`@ NormalCJ_HaJmH sH tH F@F Titre 1$ h@&^ `h5\:A : Police par dfautZi@Z Tableau Normal :V 44 la 2k 2 Aucune liste 6>@6 Titre$a$ 5CJ\B Corps de textef$ u &#$$d%d&d'd+D/NOPQa$Rg`R Machine crire HTMLCJOJPJQJe@" Prformat HTML7 2( Px 4 #\'*.25@9 CJOJPJQJ^JaJnHtHBU`1B Lien hypertexte >*B*ph0A0 eudoraheaderN@RN Texte de bullesCJOJQJ^JaJ6@b6 DEn-tte  !@ @r@ D Pied de page  !4)4 Numro de pageJ'`J b`Marque de commentaireCJaJ:@: b` CommentaireCJaJJj@J b`Objet du commentaire5\ROR_SMarge$ 7G$a$^JhmHnHsH u(W`( 7lev5\PK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭V,cy$gc.bAn̖kեC A0vs<>6r=*%@&ٖ6دk.~8$ 6./lS _//"JFV!zn^3ੵ,_wr%8/[k.$eVi2[Psjcs7f WKՆ7dg ȘJj|j(KD- dXiJ؇2x$( :'vɗsKZj{Zb&^>{?=уG]8 ˻^|ɟ>D<Ϫ~j ̜?_|+!D7!18fZNFl;I(q =9S̲8vt xur1xEu5$ IA.N&)f^݈8f2((}B*C .X;u0 ɐjmڦ1eZ3ۉm-r"+00~Hƫxp\%rcVu*#Sq= !a"e՞-%ƪL.R(_%:漌iv@}OCbU|Cp0ݷ)q}2ܢcҬ@ULC5@W4;fj8?| Tބӫg"qzr7$%G[r~KS򌅁,bm3v 1el\fp}X̕4A 6{ASLt(Q%\rl_٫fS_B,sHvx`Wr~(BshUr) 64Cebs)bMjBUkp:6GyZL3E2rQ$)9G񄨕v$5˳:Y+x%vYRnNöj.7= .Yo|%lٟ̦gl厹MPW6s;< liGY Dk/7!@Ί5( Z2_]Zѱ_3*E шMR*uahG.9gMW~#fpv4; !6o%JۍsgwŴ9R.+<+΀FS*BiDpT ߅PT/ȁa.jHP8T$Z2wzvvY,d*dL#r@Ps>=A6hן=Qr9LV638h&T-;ƬFtExZƚxY(wHH>vu[xA@U_iG08E[LZ m6:9Oc֖&g v1^<`gvbm2{Eai_dLbd_.$z ~30%M1T =0}o5PK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!Ttheme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK]  22D B D T | @{ !:<@L D FRcrDKPUZ_ =&>  "#$%&'()*+,-./0123456789;=>?AB.?5E l|!1L\gwr   G W l | XG$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$8@0(  B S  ?Check10Check1Check4Check5Check7"h2x )~ 33333-~y( J n @CC..,,IIJJbbii    9 ? ? : G h j   / 0  c4L`zӲ ItP'e'tP'1,0-rZCm_Tq_|!bzӲ V MpV{vܢ^`5CJaJo(.^`o()pLp^p`L.@ @ ^@ `.^`.L^`L.^`.^`.PLP^P`L.^`o(.^`.pLp^p`L.@ @ ^@ `.^`.L^`L.^`.^`.PLP^P`L.^`5o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.^`5o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH. h^h`o(hH. 8^8`hH. L^`LhH.  ^ `hH.  ^ `hH. xL^x`LhH. H^H`hH. ^`hH. L^`LhH.^`o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.^`o(.^`.pLp^p`L.@ @ ^@ `.^`.L^`L.^`.^`.PLP^P`L.h^`.h^`.hL^`L.h  ^ `.h\ \ ^\ `.h,L,^,`L.h^`.h^`.hL^`L.8^8`o(. ^`hH.  L^ `LhH.  ^ `hH. x^x`hH. HL^H`LhH. ^`hH. ^`hH. L^`LhH.^`o(.^`.pLp^p`L.@ @ ^@ `.^`.L^`L.^`.^`.PLP^P`L.h^h`o(. 8^8`hH. L^`LhH.  ^ `hH.  ^ `hH. xL^x`LhH. H^H`hH. ^`hH. L^`LhH.h^h`o(. 8^8`hH. L^`LhH.  ^ `hH.  ^ `hH. xL^x`LhH. H^H`hH. ^`hH. L^`LhH. ZCc!b`_-Ie' V MpV{q_1,( z#j       x        x        T        J                                            w        bap/N._ n - Z r GbI@ 8]:?` 0e"|"'$6%5A)&2T45I;?$e?|?b(BR"FRFxHaQ_SK$S'UnV`bWPXiY@[\b`IiBkV#mem|nI}XQA @@UnknownG*Ax Times New Roman5Symbol3. *Cx Arial?= * Courier NewG=  jMS Mincho-3 fg?Angsana New5. .[`)TahomaA$BCambria Math"h9'9'ò9G  !Vn24  3qHX?G2!xx PARTICIPANT S DATA SHEETPhivolcsBoned, Patrice<         Oh+'0d    , 8DLT\PARTICIPANTS DATA SHEET PhivolcsNormalBoned, Patrice2Microsoft Office Word@@z@<@{@<@{ ՜.+,D՜.+,< hp   Microsoft  PARTICIPANTS DATA SHEETPARTICIPANTS DATA SHEET TitreTitle 8@ _PID_HLINKSAh#mailto:iotws@unesco.org  !"#$%&'()*+,-./0123456789:;<=>?@ABCEFGHIJKLMNOPQRTUVWXYZ[\]^_`abcdefghijklmnopqrstuwxyz{|}Root Entry FData Dd1TableS}DWordDocument 8SummaryInformation(vDocumentSummaryInformation8~MsoDataStore0NLK1ZWEIJ==20NItem  PropertiesUCompObj r   F Document Microsoft Word 97-2003 MSWordDocWord.Document.89q