OMRS17 - Malawi Registration
Email address *
Participant Details
First Name *
Last Name (Surname) *
Preferred Name
Phone Number *
Job Title/Position
Company/Organisation Name
Are you applying for a scholarship?
Clear selection
Please email and identify the conference name 'OMRS17' to book your accommodation and to arrange your payment method directly with the hotel. For our records, please respond to the following questions.
What is your preferred Accommodation?
Clear selection
Name of preferred roommate?
Hackathon Participation - 15th and 16th December 2017
Note: Meals are not included.
Will you attend the Hackathon Sessions? *
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of OpenMRS. Report Abuse