IMDA RESEARCHER/CONSULTANT/TRAINER BANK REGISTRATION FORM

1. Name:

Mailing Address:

 

Phone/Fax:

E-Mail:

Institutional Affiliation:

 

Job Title:

University Credentials
(state subject area and the name of degree granting institution and the year):

 

Subject area of expertise:

Do you have any plans for writing a manuscript in one of the functional areas of business?

[   ]Yes [   ]No. If yes, what is the subject?

3. Are you interested in engaging in a collaborative research with colleagues from other countries? -

[   ] Yes [   ] No. If yes, what is the research topic?

 

Do you have any country and/or region preference?

[   ] Yes [   ] No. If yes, what countries and/or regions?

 

4. Work Experience(s)
(state last job first)

 

 

5. Area(s) of Expertise:

 

 

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6. Availability (duration):

[   ]Short term assignments (1 to 4 weeks)

[   ]Medium term assignments (1 to 6 months)

[   ]Long term assignments (6 to 24 months)

 

Availability (time of year):

[   ]During school holidays

[   ]During summer months

[   ]September through December

[   ]January through May

 

7. How many weeks of advance notice do you require?

 

8. What are the projects/assignments/consulting/training completed during the last three years?

 

 

 

 

9. In which countries have you worked in the past?

 

 

 

In which countries and/or regions would you like to work in the future?

 

 

 

10.Besides English, what other languages are you proficient in?

 

 

11.Fees requested
(in addition to return airfare from your home town to the place of assignment and a per diem, what would be your professional fees in U.S. Dollars?)

Please indicate:             Full Day             Five Days

Consulting

Researching

Training

Other(s)

please specify

 

12. What are your specific interests in joining International Management Development Association?

 

 

 

13. What are the two management development areas which represent your research/consulting/training interests the best?

 

[   ] Management

[   ]Marketing

[   ]Information Systems

[   ]Operations Research

[   ]Production

[   ]Accounting

[   ]Finance

[   ]Health Care

[   ]Entrepreneurship

[   ]Others (please specify)

 

Please complete and mail to:

Executive Secretary

International Management Development Association

PO. Box 216, Hummelstown, PA 17036 U.S.A.

Tel: (717) 566-3054 Fax: (717) 566-1191