EASSEMENT - ClinAcademy - Healthcare Academic & Medical Institution

Name of Trainer

Nationality

Passport

Gender

Date of Birth

Passport Expiry Date

Country of residence

Geographical Coverage

Detailed Address

E-mail address

Phone Number

Actual Occupation

Educational Background

Experience

Scientific Degree / Educational Background Qualifications

Certification / Experience in related field based on request type

List of Skills related to the trainings (i.e. presentation skills, computer skills, train the trainer, etc.)

Topics of lectures / sessions presented or done

Number of years of experience as speaker / trainer

Number of lectures presented / session given

List 5 main topics of training that you provided in the last 10 years

Languages in which trainings / programs can be provided

List of References (academic institutions / universities worked with)

Time needed in advance for training request (# of days)

Fees/day USD (excluding Logistic Fees)