Registration

Print the new registration form, fill it & send it. downoad

Pan Arab paediatric of Nephrology association
Please print this page and send it to us :

Name:
Institution:
Position/Title:
Department:
Address:
Country:
Telephone number
(country/city code):
Tele fax number
(country/city code):
Mailing address
(if different from above):

Education and Training
College or University
Degree obtained
Date:
Specialty:
Area of Interest:

Please indicate what percentage of time you spend in:
	% Research & development
	% Professional society activities and committees
	% Clinical Practice
	% Management and administration

Of which other medical societies are you a member?
e.g. PAPNA

Please provide the names of two members of PAPNA for references:
1-
2-

Signature	Date