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Address (Street, P.O. Box, City, Country)

Phone (official)

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Nationality

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Application Form

REGIONAL A$SS$$OR TRAINING IN MANILA

(Please typewrite. When finished, please insert your digital signature or print out the formand sign it. The signed application form can then be sent to AQAN Secretariat(qqan@mqa.qov.my) and in copy to Karin-Fssig, DAAD, Section Joint Higher EducationManagement (essig@daad.de) by July 3ft,2O1Z.

Contact Details

Family Name

lnstitution and department

Title First Name

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Education at Universities or Golleges

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Degree(s) or Diploma(s) ob .ned:

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Professional Experience

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Specific experience as assessor/ reviewer

(please indicate country and year of assignment, institution and programme assessed during site-visit,and the QA agency / external body in charge for QA which coordinated the assessment)

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Trainings/ seminars with relevance to quality assurance

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Language skills:

Indicatecompetenceonascaleoflto5(1 -excellent; 5-basic/Pleasenotethatagoodcommandof English is necessary to participate in the training (Add proof of English knowledge e.g. certificates,English publications or presentations if possible)

Reiding Speaking.::English

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Membership of professional bodies, academic honours etc.

References

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Place and date Signature

Please send your application incluCinq:

D Application form,

tr Letter of Motivation (1-2 pages max.)

The signed application form can then be sent to AQAN Secretariat (aqan@mqa.qov.mv)and in copy to Karin Essig, DAAD, Section Joint HigherEducation Management

31st,2012.

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Letter of Motivation

REGIONAL AS$E$SOR TRAINING IN MANILA

Please answer the following questions

1. What is the reason for your applying for the Regional Assessor Training and whatdo you expect in terms of your role as assessor / reviewer?

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2. Which topics of the training as described in the Call for Applications are mostimportant for you?lf there are any topics that you are missing, please indicate.

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Signature

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