Ethics in Public Health Practice
Email address *
Application Form
February 11 - 15, 2019
Full Name *
Please provide you complete name. It will appear on your participation certificate
Age *
Gender *
Current Designation *
Current Organisation Name *
Work experience (in years) *
Postal address *
City *
State *
Pincode *
Mobile *
Please send one-page CV (in form of .doc/.pdf) *
Please send a brief (500 words) note describing the reasons for your interest in Ethics in public health practice, your experiences in facing ethical issues/challenges in your area of work and finally, what you expect to learn from the course *
How did you first hear about this course? *
Fee Structure & Accommodation *
University will arrange the accommodation at the venue for 6 nights
Registration Fees payment
If your application is accepted, we will email payment instructions to the email ID provided in this form.
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