Application for Professional Development (Short Courses, Workshop, Seminars)

Application for Professional Development (Short Course, Workshop/Seminar)

DO YOU PREFER TO DOWNLOAD THE FORM AND APPLY MANUALLY?

Click Here to Download ACHL Program Form (Workshop/seminar/courses)

    First Name

    Last Name

    Gender

    Date of Birth

    State of Origin

    Local Government Area

    Marital Status

    Religion

    Contact Address

    Postal Address (optional)

    Permanent Home Address

    Telephone No.

    Email Address

    WHAT PROGRAM ARE YOU APPLYING FOR?

    State Title Of Short Course, Seminar Or Workshop You Applying For?

    Briefly describe your motivation for attending this program

    Have you used the computer before?

    YesNo

    Briefly list any computer program and packages you are familiar with

    How did you hear about our program?

    Would like to serve as volunteer for ACHL?

    YesNo

    If yes, fill membership volunteer form here

    © 2024 Africa Centre for Health Leadrship (ACHL) | Developer - eBrand Promotion
    About us | Contact us