Please share your WhatsApp Number (with country code, followed by number)*
Please share a link to your LinkedIn profile*
Roster category
Which roster category or categories are you applying for (select all that apply)?*
Which one of the above is your strongest / primary area of expertise?*
Relevant experience
Have you previously worked on an Ebola response?*
If the answer to the previous question is yes, please share more information on country, year, organisation / employer, role. duration, brief description of responsibilities.*
Have you worked on any other infectious disease outbreak or public health emergency response? Examples: Marburg, cholera, COVID-19, mpox, measles, yellow fever, plague, meningitis or other epidemic response. *
If the answer to the previous question is yes, then please share more details*
Have you worked in humanitarian, fragile, conflict-affected, remote or access-constrained environments?*
If the answer to the previous question is yes, then please provide details, including countries, organisations and roles*
Have you worked with any of the following organisations or response structures? Please select all that apply.*
If the answer to the previous question was other, please specifiy*
Country and regional experience
Which countries have you worked in professionally?*
Have you worked in the Democratic Republic of Congo?*
If your answer to the previous question was yes, please specify: Province / location, organisation, role, dates.*
Have you worked in any neighbouring or regionally relevant countries? Examples: Uganda, Rwanda, Burundi, South Sudan, Central African Republic, Republic of Congo, Tanzania, Kenya or others. *
If your answer to the previous question was yes, then please specify*
Language capability
What is your English proficiency?*
What is your French proficiency?*
Which other languages do you speak professionally? Please specify level of proficiency, particularly for Swahili*
Are you able to conduct community engagement, interviews, training, coordination or reporting in French or local languages?*
If yes, please specify the language(s) and context. *
Technical experience
Please briefly describe your most relevant technical experience for the roster category or categories you selected.*
Please select the activities you have direct experience in. Please select all that apply. *
If your answer to the previous question was other, then please specify.*
What tools, systems, standards or protocols have you used that are relevant to outbreak response or humanitarian emergency response? Examples: DHIS2, Kobo, ODK, Excel, Power BI, Epi Info, GIS tools, IPC protocols, WASH standards, logistics systems, safeguarding / PSEA frameworks. *
Deployment readiness
Are you currently available for deployment?*
If your answer to the previous question was other, then please specify.*
Are you open to short-notice deployment?*
What is your preferred assignment duration?*
Are you willing to work in Ebola-affected or at-risk areas, subject to security, medical and contractual arrangements?*
Are you willing to work in remote, high-pressure or insecure environments?*
Do you have a valid passport?*
If your answer to the previous question was yes, please provide passport expiry date.*
Do you currently hold any visas, work permits or residency status that may support regional deployment?*
Do you have any restrictions that may affect deployment? Examples: family obligations, medical limitations, visa restrictions, employer notice period, travel limitations. *
Training, certification and documentation
What is your highest relevant qualification?*
Do you hold any professional registration, licence or certification relevant to your role?*
If your answer to the previous question was yes, please specify.*
Have you completed any relevant outbreak-response, emergency-response, humanitarian, safety or security training? Please select all that apply. *
If your answer to the previous question was yes, please specify.*
Are you able to provide copies of relevant qualifications, licences, certifications or training records if requested?*
Safety, security and conduct
Have you previously worked under security restrictions, curfew, movement control or armed escort arrangements?*
If your answer to the previous question was yes, then please provide examples.*
Are you willing to comply with strict IPC, PPE, safety, security and movement protocols during deployment?*
Are you familiar with safeguarding, PSEA, confidentiality and do-no-harm principles?*
If your answer to the previous question was yes, please provide examples of relevant training or experience*
Do you have any medical condition or limitation that may affect deployment to a high-risk emergency setting?*
Compensation and contracting
What is your current or most recent daily / monthly consulting rate? Please specify currency and whether it is daily or monthly *
What is your expected daily / monthly rate for emergency deployment? Please specify currency and whether it is daily or monthly *
Are you open to CTG consultant contracting arrangements*
Are you currently employed or under contract?*
If your answer to the previous question was yes, please specify your notice period.*
References and consent
Please provide at least two professional references from previous emergency, public health, humanitarian or field assignments?*
Are you willing to undergo reference checks, compliance screening and client review if shortlisted?*
Candidate statement
Why are you interested in joining CTG’s Ebola Response Roster?*
Is there anything else CTG should know about your experience, availability or suitability for emergency response deployment?*