Sudan- Expression of Interest: Pool of Experts - Course Facilitation Please fill this form to express your interest in joining the pool of experts for course facilitation within the Crisis Leadership Programme. Step 1Personal DetailsTitle(Required)Mr.Mrs.Ms.MissOtherFirst Name(Required) Last Name(Required) Pronouns(Required)She/HerHe/HimThey/ThemOtherIf other, please specify Email(Required) Phone(Required)Where are you based?(Required) City State / Province / Region AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Step 2Your InformationHighest Completed Qualification(Required)Bachelor DegreeGraduate CertificateMaster DegreePHD/Doctoral DegreeWhat is the name of the institution where you attained your highest level of education?(Required) What did you major in?(Required) Have you had any experience in working on the Sudan Crisis?(Required)YesNoIf yes, please list your position, duration of employment, organisation and duties:Please make sure to include the duties, duration of employment and organisation for each position. Add RemoveStep 3Resume & Facilitation ExperienceYears of previous experience in the course facilitation(Required)Courses/trainings Facilitated(Required)Please list courses/trainings facilitated or delivered, topics covered and organisation worked with Add RemoveUpload Your Resume/CV(Required) Drag files here or browse your computer Max. file size: 64 MB.Certifications (if any)*(Required)Please list certifications, year acquired and certifying organisations/body Add RemovePreferred Course to Facilitate(Required) CLP Seed CLP Grow No preference Select AllLanguage of Facilitation(Required) English Arabic Select AllDaily Rate (in USD)(Required)The daily rate is the rate charged for each day of work noting that the average number of days required per course ranges between 8 –11 days. Availability(Required)While the centre will confirm with you on availability prior to each course iterations, please advise/flag time frames where you will not be available.Upload Supporting Document(s)(Required) Drop files here or Select files Max. file size: 64 MB. Please upload any certifications you have, your highest attained degree and any other relevant documents.Other Information to Add/Flag?Consent I agree to the privacy policy.Deakin University (Deakin), through the Centre for Humanitarian Leadership (CHL), is collecting your personal information for the primary purpose of an expression of interest for the Crisis Leadership Program (CLP) course offerings: Seed, Grow and Extend. Deakin will use this information to communicate with you about the CLP. Deakin will not disclose your personal information to any third party without your written consent. You are not required to provide the information requested, however if the information is not provided Deakin may not be able to communicate with you about the CLP. Your information will be retained for a period of 12 months. Deakin collects, uses, discloses, and manages personal information it holds, including requests by individuals for access to their personal information in accordance with the Privacy and Data Protection Act 2014 (Vic) and the Health Records Act 2001 (Vic). Further information about Deakin’s privacy practices is available at http://www.deakin.edu.au/footer/privacy