REPORTING TO THE UNITED NATIONS HUMAN RIGHTS TREATY BODIES TRAINING GUIDE: Part II — Notes for Facilitators ANNEX 1 SAMPLE PRE-COURSE QUESTIONNAIRE/APPLICATION FORM [Title of training course] [Venue and date] Application Form 1. Personal information Title:____________________________________________________________________________________ First name: _________________________________ Last name: __________________________________ Profession:______________________________________________________________________________ Current employer:________________________________________________________________________ Current position:_________________________________________________________________________ Department/Ministry:_____________________________________________________________________ Full address:_____________________________________________________________________________ E-mail:__________________________________________________________________________________ Telephone (office):________________________________________________________________________ Telephone (mobile):_______________________________________________________________________ Nationality:_____________________________________________________________________________ Sex:____________________________________________________________________________________ Date of birth:____________________________________________________________________________ Place of birth (town and country):___________________________________________________________ Passport number:_________________________________________________________________________ 2. Qualifications Languages English:  Native  Fluent  Comfortable  Not comfortable Other languages:________________________________________________________________________ Education School education (list 3 highest qualifications): _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ Other 82 Publications (optional): ___________________________________________________________________