PPP Certification Application Public Utility Research Center PPP Certification Application Step 1 of 4 - Personal Information 0% Public-Private Partnerships Foundation-Level Certification June 16 - 19, 2020 - Gainesville, Florida Currently accepting applications. This PPP training is offered as part of the larger PURC/World Bank International Training Program on Utility Regulation and Strategy. Application for Admission Please submit your information today to be considered for acceptance. 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. Applicants will be selected according to their current position and relevant professional expertise and to maintain cross-sectoral, cross-regional, and national balance. Accepted applicants will be informed via email immediately after a decision on their application is reached (usually 3-5 business days.) 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. 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. Salutation*Mr.Mrs.Ms.First Name/Given*Middle NameLast Name/Family/Surname*Name for Badge*Phone*include city and country codeFaxinclude city and country codeEmail* Enter Email Confirm Email Emergency Contact*NamePhoneEmail Title of Present Position*Institution/Company*Company Website Work Address*Street AddressAddress Line 2*CityState / Province / RegionZip / Postal Code*AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech 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 TobagoTunisiaTurkeyTurks & Caicos IslandsTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabweCountryWhich infrastructure sector(s) are you personally involved in regulating or operating?* Energy Gas Telecom Water Other Other infrastructure you are personally involved in regulating/operatingNumber of staff dedicated to regulatory tasks (for regulators only)Number of individuals employed by your company (for infrastructure companies only)Number of employees you actively manage (for company employees only)Describe your current duties* Please describe your reasons for wishing to participate in the training program and your expectations of it*How did you hear about our training program? Please check all that apply. Required training for my position From a colleague Email Notice Mailed Brochure Online Search Other If "Other" please let us know how you heard about usDietary Preferences/Food AllergiesBed Preferences*One king-sized bedTwo double bedsWill you be accompanied by a non-participant(s)?NoYesPURC is excited to offer a one-day leadership workshop, Practicing Leadership in a Political Environment, following the PPP program on Saturday, June 20, 2020. This workshop uses the unique political environment of the utility regulatory space to examine the mindsets and behaviors that help those in leadership roles be more effective at making an impact in their organization and their country. Find additional information about the workshop. I would also like to attend the PURC leadership workshop, Practicing Leadership in a Political Environment. Course fee only USD $595 (Saturday, June 20, 2020).*This workshop will provide participants with methods for analyzing the health of their organization, techniques for providing leadership in complex situations, approaches for understanding and managing political context, and an action plan for addressing a pressing leadership challenge. Our participants who attend say that it dramatically impacts their effectiveness as leaders. NoYes Payment Full payment must be received by the payment deadline, Friday, April 24, 2020, 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. Payment Policy*I understand that if I am accepted to participate in the program, proof of payment for my attendance will be due Friday, April 24, 2020 (USD$2,975). I will submit proof of payment via fax to (+1) 352-392-7796 or via email (firstname.lastname@example.org) by April 24, 2020. I understand the payment policy CancellationCancellation Policy*I understand that cancellation(s) must be sent to PURC in writing on or before Friday, May 1, 2020 for a refund, minus a 20% cancellation fee. After May 1st, no refunds will be granted. Qualified substitutions can be considered. I understand the cancellation policy Submit the FormPlease press the Submit button only once to avoid multiple applications. You will receive a confirmation email after you submit your information.PhoneThis field is for validation purposes and should be left unchanged.