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Name
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Gender
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Phone number
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Email address
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Course applied for:
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Sub-Grants Management Training
Geographic Information Systems/Global Positioning Systems
Point of Care Ultrascan Training
Profession/Cadre
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Place of work
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Reason for applying for the course:
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Sponsorship type
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Self-sponsorship
Organisation/institutional sponsorship
Are you willing to attend classroom-based training sessions?
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