TRAINING REGISTRATION FORM
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Date *
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DD
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First Name *
Middle Name
Last Name *
 Discipline/Profession
Years of Working Experience *
Contact Address
Name of Organisation
Country of Residence *
Email *
Education Level
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Phone Number *
Alternative Phone number
Please Specify your time zone? eg. (UTC+01:00) West Central Africa *
Name of Training *
Preferred Mode of Training? *
Reason for the Training *
Do you want to be Certified
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If Yes, When?
MM
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DD
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YYYY
Mode of Payment *
Comment
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