Please enable JavaScript in your browser to complete this form.Name *FirstLastGenderMaleFemaleContact addressPhone noEmail *Your professionDoctorNurseMedical StudentNursing StudentPharmacistOther Health workersClergy/ChaplainOther non-medical professionWhat time of the day will you prefer for the main courses? (Nigerian time)Early 4:30-6:00amLate 8:30 - 10:00pmBoth on different daysAre you born again?YesNoNot sureIf yes, give a brief testimony of your salvation experienceWhat are your expectations from this training course? *Submit
