KHIBRA Engagement Form

Full Name *

Email address *

Mobile/Phone Number *

Date of birth *

Nationality * Select - Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Arabic Countries Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Central African Republic Chad Chile China China (Taiwan) Christmas Island Cocos (Keeling) Islands Colombia Comoros Islands Congo Congo, DR (Zaire) Cook Islands Costa Rica Cote d'lvoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Embassy in U.A.E Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard Island & McDonald Island Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Italy Jamaica Japan Jordan Kazakhastan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar (Burma) Namibia Nauru Nepal Netherlands Netherlands Antilles New Calcdonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Other Counties Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Republic of Kosovo Republic of Montenegro Republic of Serbia Reunion Romania Russia Rwanda Saint Helena Saint Lucia Saint Pierre and Miquelon Samoa San Marino Sandwich Islands Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Korea Spain Sri Lanka St. Kitts and Nevis St. Vincent and Grenadines Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Tajikistan Tanzania Thailand Timor Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine Union Des Comores United Arab Emirates United Kingdom United States Minor Outlying United States of America Unknown Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Without Nationality Yemen Zambia Zimbabwe

UAEU Graduate Date *

degree * Select Diploma bachelor Masters Phd

First Language *

Second Language *

Current Employer *

Job Title *

field of experience *

years of experience *

Do you conduct training / deliver lecturers in your field ? * Select Yes No

What kind of groups you prefer to lecture? * University Students,Others (Please Metion)

University Students

Others (Please Metion)

Please tick any of these skill areas if they relate to you:

Training / Mentoring

Knowledge sharing in any specific area

Experience working with University Students

Others:

What is preferable delivery methods? * Select Virtual / Online In-Person

Brief and title *

Duration: *

Period of availability: *

3. Declaration

I attest that the information supplied is true and accurate. I understand that submitting this application form does not automatically register me a volunteer lecturer or mentor but that there is a selection process. I confirm that I am willing to volunteer as a lecturer or mentor for Khibra of UAEU.

Submit