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Funder Course Application

Application Form for the CGAP Training Course “Building Financial Systems for the Poor: How Funders Can Make a Difference”
A Five-day Training Course for Donors, Socially Responsible Investors and Policy Makers

If you have any difficulties submitting this form electronically, please contact Natasa Goronja
(E-mail ngoronja@themfmi.org)
Course tuition fee is US $1,900 (Early registration is $1,750)
For the Spanish language application for the Mexico City training, click here.

Social Title:	Dr. Mr. Ms.
First Name:
Last Name:
Job Title:
Organization:
Address 1:
Address 2:
City:
State/Province:
Postal Code:
Country:
Phone Number(s):
Fax Number(s):
E-mail address:

We would like to learn more about your work and level of involvement in microfinance. When answering the following questions please bear in mind that it is acceptable for trainees to have little or no experience with microfinance and/or financial analysis.

Are you (and/or your agency) currently funding microfinance initiatives?	Yes No

If so, please provide details. If not, please advise whether you intend to do so in the near future.

Do you have any experience in microfinance?	Yes No

If so, please provide details. If not, please advise whether you intend to work in this field in the near future.

Do you have experience dealing with financial statements and microfinance ratios?	Yes No

If yes, please specify.

What do you expect to learn from this course?

How do you anticipate applying what you have learned?

What is your level of spoken and written English?

Application Process:
By submitting this enrollment form you confirm your interest in the course and your intention to cover all participation costs including tuition fees. CGAP will review your application and inform you whether you have been accepted or not as quickly as possible. Successful applicants will receive formal confirmation and additional logistical information. A $750 charge will apply to all confirmed participants who cancel 10 or more days before the course begins. Confirmed participants who cancel less than nine days before the course begins will be charged $1,900.

Insurance: Tuition does not include basic accident & health coverage.
Liability: Participants are personally responsible for all charges/expenses incurred during the workshop.

I declare that I understand and agree to all terms and conditions outlined in the Application Form above.