AfreHealth - Institutional Registration Form

Menu

Home
About us
Opportunities
Conferences and Events
Media
Documents
Registration
- Individual Membership Form
- Institutional Registration Form
Contact us

Institutional Membership Form

Name of Institution(*)

Invalid Input

Principal area of operation / activity (Please tick or type where applicable)

EDUCATION

(i) Health(ii) Sciences(iii) Liberal Arts(iv) Law Invalid Input

Others – supportive (funding, logistics)

Invalid Input

RESEARCH

(i) Health (ii) Sciences(iii) Education Invalid Input

Other(s) – support (funding, logistics)

Invalid Input

Applied Professions / Disciplines (Nutrition/Dietetics, Physiotherapy, Rehabilitation, Social Works, etc.)

Invalid Input

Non-profit / Non-Government Organizations – NGO (specify type)

Invalid Input

Other(s) (specify details, etc.)

Invalid Input

Address of Institution

Physical / Legal address (Street, City, Country)

Invalid Input

Official Contacts (Telephone, Website / e -mail address , etc.)

Invalid Input

HQ address in Africa (o cially registered)

Invalid Input

HQ address (International, outside Africa)

Invalid Input

Status of Applicant

GovernmentPrivateBusiness Invalid Input

Other (specify)

Invalid Input

Source(s) of funding for over-all operationa of the Applicant (etc.)

GovernmentPrivate Invalid Input

Other, Specify

Invalid Input

How does your insitution hope to benefit from AFREhealth membership?

Invalid Input

How do you think AFREhealth will benefit from your membership?

Invalid Input

Name

Invalid Input

E-mail(*)

Invalid Input

Position

Invalid Input

Signature

Invalid Input

Date

Invalid Input

Latest News

4th Annual Symposium 15 January 2020

AFREhealth appoints new Finance Manager 09 December 2019

Consultant - Membership Development, Marketing and Strategic Communication 14 November 2019

AFREhealth Symposium Summary - Africa Health Journal 08 November 2019

UNGA Education Side Event 03 October 2019

About us

The African Forum for Research and Education in Health (AFREhealth) is an interdisciplinary health professional grouping that seeks to work with Ministries of Health, training institutions and other stakeholders to improve the quality of health care in Africa through research, education and capacity building.

Past Symposia

Symposium 2018 - South Africa
Symposium 2017 - Ghana

Contact Us

Tel: +233508351306 / +233555324168
Email: afrehealth@gmail.com | info@afrehealth.org

Copyright © 2020 The African Forum for Research and Education in Health. All Rights Reserved.

Home
About us
Opportunities
Conferences and Events
Media
Documents
Registration
- Individual Membership Form
- Institutional Registration Form
Contact us