Register – Ghana Health Informatics Association

GHIA Application Form

Membership Type

Username

E-mail Address

Password

Confirm Password

Background Information

First Name

Last Name

Birth Date

Gender

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Contact Information

Mobile Number

Phone Number

Address

City

State / Province / Region

Country

Academic Qualification

Highest Qualification

Institution

Date of Completion

Professional Qualification 1

Professional Qualification 2

Professional Qualification 3

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