Name:
Surname:
Training Course Applied for:	Tick as appropriate Member of Local Organisation General Public
Name of Organisation (if applicable):
If you form part of a Local Organisation, kindly indicate preference for date/day/time of training course: Training course for general public/local organizations lasts 2 hours If you have no particular preference, kindly say so
Date:
Day:
Am/Pm:
Kindly indicate preferred locality of the training course:
Locality:
Topics of Interest to be covered during Training (Kindly number the following in order of preference, with 1 being the first preference, 2 the second preference, etc):
	Gender Issues and concepts
	Gender and Family Issues
	Gender and Decision-making
	Gender and Entrepreneurship
	Gender and Employment
	Gender and Education
	Gender and Leisure
Contact Details of Individual/Organisation:
Telephone No and/or Mobile No:
Email:
Kindly indicate whether you would require a Venue for the Training Course:
	Yes
	No, venue is already available
If venue is already available, kindly indicate address of Venue:
Address of Venue: