Food Safety Short Course Application
      June 4th – July 6th, 2018
              Kyiv, Ukraine

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* 1. Print your name

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* 2. What is your gender?

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* 3. What is your age?

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* 4. What is the highest level of education you have obtained at this point in time?

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* 5. If you are currently enrolled in the University, what year of school are you in?

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* 6. What is your enrollment status? Full time, part time or other-please specify. 

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* 7. If currently enrolled, what has been your average overall performance?

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* 8. If enrolled in a BA/ BS program, do you anticipate enrolling in an advanced degree program (MS, MA, MBA, PhD) after graduation?

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* 9. What is or has been your area of study? You may include more than one, if applicable.

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* 10. Do you have access to the internet? Please check in the appropriate boxes.

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* 11. What languages do you speak? Please specify.

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* 12. If you also speak English, when did you start learning English?

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* 13. Have you taken ‘English as a Secondary Language’ classes in the past?

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* 14. If you answered 'yes' to the above question, for how long have you taken ‘English as a Secondary Language’ classes in the past?

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* 15. Have you ever lived or traveled in an English-speaking country?
If yes, please mention the name of the country/ies and the time you spent.

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* 16. How well can you do the following in English? Please check in the appropriate boxes.

  Very poor Poor Fair Good Very good
Reading
Speaking 
Writing
Listening 

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* 17. Have you taken any food science-related courses in the past?

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* 18. If you answered 'yes' to the above question, which food science-related courses have you taken? Please specify.

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* 19. Have you ever participated in a food safety training course? For example: HACCP, FSMA, FSPCA etc.

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* 20. Have you ever worked in the food industry? If yes, what type of industry (ex. beverage, meat, poultry, dairy, produce, etc.)?

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* 21. How interested are you in working in the food industry in the near future?

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* 22. Please describe why you should be considered for this Food Safety Short Course program. Respond with approximately 250 words. Please upload your response.

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