Expression of Interest: Submission Form  
Indlela is pleased to release an EOI for a virtual Behavioural Insights Test (BIT) development workshop series. Deadline for the EOI is Friday, November 6, 2020. Please note that we encourage early applications. Please answer all questions, or give a reason for not doing so. If you have any questions about the application or the workshop, please contact us at indlela@heroza.org.

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Applicant Details
Name and surname *
Degree(s) *
Email address *
Type of work that you do (check all boxes that apply): *
Required
Please briefly describe 2-3 of your main professional responsibilities as they relate to HIV programmes. If you work for an implementer of HIV services in South Africa, this can include specific responsibilities within the HIV programme. If you are based in a research institution or department, describe the type of research you have done. *
Optional: List up to 3 recent publications, if any:
Details of your Institution
Name of institution *
Institution Type (check box that is most applicable) *
Required
What are your institution’s main key activities? *
In which province/s are your institution’s HIV programmes implemented? *
If you work at a research institution, which organizations or government organizations do you collaborate with in research projects related to HIV service delivery? *
Required
Experience of Behavioural Challenges
During the workshops, further time will be allocated to identifying potential BIT opportunities, your responses below are not binding.
Please list up to 5 behavioural challenges you have experienced in your work and/or within your HIV programmes related to the following areas of the HIV care cascade (HIV testing; HIV linkage to care; Adherence or retention in care of patients on ART). *
Motivation for workshop participation
Personal statement: Please describe briefly (250 words or less) why you want to participate in the BIT Development Workshops? Please include how your participation in this workshop will support your or your organizations work currently or in the future. *
Optional: Please email a letter of support from your institution, stating your organization’s interest in incorporating behavioral economics in your projects. Email address: indlela@heroza.org
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