Embed Size (px)
Citation preview
International Federation of Freight Forwarders Associations Schaffhauserstrasse 104, P.O. Box 364,CH-8152 Glattburgg, Switzerland
Tel. +41(0)43 211 65 00, Fax +41 (0)43 211 56 65 E-mail [email protected], Internet http://www.fiata.com
APPLICATION FORM FOR THE
FIATA HIGHER DIPLOMA IN SUPPLY CHAIN MANAGEMENT
Personal information to be completed by the applicant (will be treated strictly confidential )
Title: Mr Mrs Ms
Family Name:
Forename(s):
Date of birth: Day Month Year
ID number:
Private Address
Street:
Town and Postal Code:
Country:
Business Address
Company name:
Street:
Town and Postal Code:
Country:
Phone: Fax:
E-mail Website:
Please indicate your name as it should appear on the Higher Diploma
I the undersigned, in the case of a FIATA Diploma being delivered to me, authorize FIATA to publish my
name and country of residence/ work in the Diploma- Holders Section of the FIATA website
( www.fiata.com) . Date: Name: Signature
