International Training Program Application | PURC

34th PURC/World Bank International Training Program on Utility Regulation & Strategy

June 10-21, 2013 - Gainesville, Florida

Application for Admission

This application form has been designed to obtain all the information we may need from you during the application/registration process to attend our program. We ask that you please submit clear and accurate information to avoid any delays. Our Admissions Committee will review your application as soon as possible. Accepted applicants will be informed via email immediately after a decision on their application is reached.

Qualified applications received after April 12, 2013 will be accepted based on availability. We encourage all applicants to submit their applications as early as possible so that they have enough time to obtain an entry visa to the USA if needed, etc.

Note: The sessions will be conducted in English, so participants must have a good command of this language.

Please fill out all fields on the form below. *Required fields.
Or, fill out the print-friendly application instead.

Personal Information

Title*

Select one.

Family/surname/last name*

Given/first name*

Middle name

Name for badge*

Telephone*
include city and country code

Fax
include city and country code

Email*

Website

Emergency contact*
name, phone, fax

Job Details

Title of present position*

Institution/company*

Work street address*

Work city*

Work state*

Work zip/postal code*

Work country*

Which infrastructure sector(s) are you personally involved in regulating or operating?*

Electricity
Gas
Telecom
Water
Other:

Check all that apply.

Please list the other infrastructure sector(s) you are involved with.

Number of staff dedicated to regulatory tasks
for regulators only

Number of individuals employed by your company
for infrastructure companies only

Number of employees in activity you manage
for company employees only

Describe your current duties*

Please check whether you are personally involved in the following types of issues*

Determination of market structure issues
Design and administration of infrastructure arrangements with private sector providers (e.g., divestiture, concession, license, lease)
Determination of regulated prices
Determination of quality/performance standards
Administration of competition rules in regulated sectors
Administration of subsidies and transfers to low-income groups

Check all that apply.

Previous Positions

Position #1*

Company/Institution*

Dates*

Duties*

Position #2*

Company/Institution*

Dates*

Duties*

Training Program

Please describe your reasons for wishing to participate in the training program, and your expectations of it*

Dietary preferences/food allergies*

Hotel Room

Bed preferences*

One king-sized bed Two double beds

Select one.

Smoking preferences*

Non-smoking Smoking

Select one.

Will you be accompanied by a non-participant(s)?*

Yes No If so, how many?

Select one.

I plan to attend the Basic Economic Training Session*
(Sunday, June 9, 2013)

Yes No

Select one.

I would also like to attend the PURC leadership workshop, for only US $595.*
(Saturday, June 22, 2013)

Yes No

Select one.

Payment

Applicants will be selected according to their current position and relevant professional expertise and to maintain cross-sectoral, cross-regional, and national balance.

Full payment must be received by the payment deadline, Friday, April 26, 2013, in order to guarantee your seat at the program. If full payment is received after the payment deadline and should there be seats available, this may result in alternate hotel accommodations arranged at the discretion of the PURC Program Committee.

I understand that if I am accepted to participate in the program, proof of payment for my attendance will be due Friday, April 26, 2013 (US$6,700 for regulators or US$7,900 for staff from private or public infrastructure companies). I will submit proof of payment via fax to (+1) 352-392-7796 or via email (purcecon at warrington.ufl.edu) by April 26, 2013.

Accept payment terms.

Cancellation Policy

I understand that cancellation(s) must be sent to PURC in writing on or before Friday, May 3, 2013 for a refund, minus a US$600.00 cancellation fee. After May 3, 2013, only 70% of the fee will be refundable (with additional charges for no-shows).

Accept cancellation terms.

You will receive a confirmation email after you submit your information.
Please press the submit button once only.