SEMINAR ON NON-REVENUE WATER REDUCTION AND WASTE WATER MANAGEMENT
NEEDS ASSESSMENT FORM
Please fill up the form with complete information. This would be the basis for refining the design of the activity. All
responses will be treated with confidentiality. Thank you very much.
I. BASIC INFORMATION
FULL NAME
AGE
GENDER
Educational Attainment (check the appropriate box):
NICKNAME
STATUS
[ High School Undergraduate
High School Graduate
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College Undergraduate
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College Graduate (
[Typ
COURSE: ____________________________________________________
Typ
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II.aTyp
Trainings and Workshops Attended (past 5 years only)
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TITLE OF THE TRAINING/WORKSHOP
SPONSORING ORGANIZATION/AGENCY
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Organizational Affiliation
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ORGANIZATION
YEAR JOINED
CURRENT POSITION
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IV.d
Training Context
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What
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NRW Reduction Training
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TNA Form/ FIB/92012
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How would you use the learning from this training in your work?
What are your expectations in attending this training?
What are your limitations (physical, diet restrictions, time, language, method, etc)?
Other concerns:
NRW Reduction Training
TNA Form/ FIB/92012