RIA Online Application Page Public Utility Research Center RIA Online Application Page RIA Online Application Step 1 of 3 - Personal Information 0% Course begins November 1, 2021 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 training course. 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 is reached on their application. 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, or fill out the print-friendly application instead. By providing information on this application, you agree to receive emails from PURC. You may unsubscribe at any time. PURC does not share or sell your contact information. Title*-please select-Mr.Ms.Mrs.MissDr.First Name/Given* Middle Name Last Name/Family/Surname* Phone*FaxEmail* Enter Email Confirm Email Website Title of Present Position* Institution/Company* Work Address* Street AddressAddress Line 2 Address Line 2City* CityState / Province / Region State / Province / RegionZip / Postal Code Zip / Postal CodeCountry*AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabweCountryWhich infrastructure sector(s) are you personally involved in regulating or operating?* Electricity Gas Telecom Water Other Other infrastructure you are personally involved in regulating/operating Describe your current duties* Course Schedule*I understand this course is delivered online over a six week period (November 1 - December 10, 2021). In order to receive my certificate of completion, I understand all course work must be submitted no later than Friday, December 17, 2021. Internet access is required to complete the course. I understand the course schedule Payment Policy*I understand that if I am accepted to participate in the course, proof of payment for my attendance is due by Friday, October 22, 2021 USD $1495. I will submit proof of payment via fax to (+1) 352-392-7796 or via email (firstname.lastname@example.org). Course fee includes: Program tuition, reading and online classroom material, and 6 Live hour-long sessions via Zoom with the PURC faculty. I understand the payment policy Cancellation Policy*Payments received are non-refundable. In the event the accepted applicant cannot participate in the course, their registration and payment can be deferred to a future online course. Substitutions are also allowed. I understand the cancellation policy Please press the Submit button only once to avoid multiple applications. You will receive a confirmation email after you submit your information.NameThis field is for validation purposes and should be left unchanged.