Registration Form
Designation *
Select your designation
Professor
Medical Doctor
Resident
Medical Student
Non-Medical Student
Full Name *
Organization *
Country *
Select your country
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Congo - Brazzaville
Congo - Kinshasa
Côte d’Ivoire
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Guinea
Guinea-Bissau
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Mayotte
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Réunion
Saint Helena
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Sudan
Swaziland
São Tomé and Príncipe
Tanzania
Togo
Tunisia
Uganda
Western Sahara
Zambia
Zimbabwe
Email Address *
Phone Number *
What is your Education Background and Experience: *
What are your objectives for this training course: *
How will you know that you have achieved your objectives: *