WASH in Healthcare Facilities Distance Learning Course Registration Form (Spring 2021)
Developed and led by the Center for Global Safe WASH at Emory University with UNICEF.

This course runs for 10 weeks and includes 8 live sessions.
Dates of live virtual class include: March 16, 23; Apr 6, 13, 27; May 4, 11, 18 from 8:00AM - 9:30AM EDT (please note that the US will be on daylight savings time).

For more information about the course:
https://sph.emory.edu/departments/gh/continuing-ed/index.html
Email address *
First Name: *
Last Name: *
Work Phone Number:
Country of Residence: *
Country(s) of Operation: *
Organization: *
Department/Division (if applicable):
Job Title: *
Brief description of the responsibilities of your current position: *
Length of time at your current position: *
Are you trained as a: (select all that apply) *
Required
Do you self-identify as working with the: *
Have you previously been involved in WASH in Healthcare Facilities programming/activities? *
If yes, what?
What do you hope to gain from this course? *
Other notes for instructors:
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