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Arrange a Workshop Form: Administration and Participant Details.
TYPE OF WORKSHOP
STANDARD Workshop - 3Hrs, 10-12 Participants
EXTENDED Workshop - 6Hrs, 15-18 Participants
TRAIN-THE-TRAINERS Workshop - 3Hrs, 6-8 Participants
HOSPITAL/ORGANISATION
Hospital/Organisation
*
Address
*
Date of workshop
-
Day
-
Month
at
Year
/
Hour
Minutes
AM
PM
Timezone
*
Session times
*
Location of workshop
*
COORDINATOR
Coordinator's name
*
Position
*
Phone
*
Email
*
CONTACT if not same as coordinator
Contact's name
Position
Phone
Email
PARTICIPANTS
* It is imperative that emails provided are correct.
* The name that is given will appear on the Certificate of Completion.
1.Name
1.Email
2.Name
2.Email
3.Name
3.Email
4.Name
4.Email
5.Name
5.Email
6.Name
6.Email
7.Name
7.Email
8.Name
8.Email
9.Name
9.Email
10.Name
10.Email
11.Name
11.Email
12.Name
12.Email
13.Name
13.Email
14.Name
14.Email
15.Name
15.Email
16.Name
16.Email
17.Name
17.Email
18.Name
18.Email
19.Name
19.Email
20.Name
20.Email
NOTES
Notes
Submit
Should be Empty:
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