Application for IGA- WB Fellowship Opportunity For the short course: “Reducing Drilling Risk from Exploration to Field Management” (17–19 April 2015, Melbourne, Australia) Conditions of the Fellowship are: 1. The fellow attends the three day short course “Reducing Drilling Risk from Exploration to Field Management” 2. The fellow is not accepted as fellow in the general WGC2015 fellowship program. 3. The fellow is citizen of a low/middle (lower, upper) income country according to the World Bank country classification1. Classification Low income Lower middle income Upper middle income High income Income (GNI per capita, 2013) $1,045 or less $1,045 to $4,125 $4,125 to $12,746 $12,746 or more The fellowship includes up to USD 2.000 as lump sum to each fellow in cash during the onsite registration at the registration desk. There will be no other or additional payments. The accepted fellows do not need to pay any participation fees for the short course. The accepted fellows have not to register using the registration forms for the congress- short courses. The course registration for accepted fellows will be automatic through the IGA. 1 Click here to view the countries eligible for a Category A registration. Click here to view countries eligible for Category B registration.For more information please visit the World Bank country classification site or visit the country classifications section of the knowledge base. Application Please submit this form and an additional application letter via Email to the IGA Secretariat ([email protected]) by 31 January 2015. A CV in addition is appreciated and helps to select candidates. The application letter should contain the following information: a) Your position and main work in your company/ institution, b) Your relation to geothermal issues, and c) Reasons for attending the short course. Application Form to be filled in: First Name Family Name Email Address Company Name of reference person University/ Institute/ Affiliation Street Address Extra Address Line (optional) City State Zip Country of residence Nationality by birth Phone Fax Alternative Email address IGA member? Yes No Member of national geothermal association? Which one? Do you receive any partial support to attend the WGC2015 or a short course from other sources? Yes ____ No ____ If yes, amount in USD: _________