Survey | Qualtrics Survey Software

Below is a short survey that you need to complete in order to request an application to attend the MDI - SA 2009. Based on your response to the survey, we will either send you a full registration form in Microsoft Word or inform you of the reasons for the denial of your request for application and may request further information from you.

If your request is approved, the application will be sent as an attachment to the email you provide below. Once you receive the application, you will need to complete and send it as an email or fax. Detailed instructions will be provided in the email.

Personal Information

Email
Verify Email
Prefix (Mr. Mrs. Ms. etc)
First Name
Last Name
Job Title
Company/Organization
Country

Experience

How many years of experience do you have in the microfinance and/or microenterprise development fields?

Please describe which area you have primarily worked in.

Microfinance
Business Development Services
Both MF and BDS
Value Chain Development
Other

Please describe

Please describe the microfinance and/or BDS methodologies you are most familiar with and what your specific responsibilities are/were in your most recent position.

Please rate your ability to speak English

My ability to speak English is Excellent
My ability to speak English is Fair
My ability to speak English is Poor

Please rate your ability to read and write in English

My ability to read and write in English is Excellent
My ability to read and write in English is Fair
My ability to read and write in English is Poor

Please describe who is paying the tuition and travel costs for you to attend the MDI-Shouthern Africa 09 and if you have already secured funding?

Do you certify that the statements made above are true and that the full tuition and other costs due will be paid before or upon arrival at the MDI-Southern Africa 2009?(please select)

No
Yes