African Gong - Membership Application Form
Thank you for your interest in African Gong. We will respond to you in due course and update you on the status of your application.

Please note that the personal information that you provide in this Membership Application Form will only be used by African Gong legitimately and with full respect for your privacy and confidentiality, for the purpose of maintaining a membership database so as to further inform you about important African Gong matters, on a regular basis. It will be kept in strict confidence in electronic form, and will not be shared with any third party entity.  
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Email *
First Name *
Surname *
Title *
Nationality (ties) *
Gender *
What is your motivation for applying to become a member of African Gong? *
Category of Membership *
If you selected individual, please indicate you age range *
Highest level Qualification *
Profession (area of work/ expertise) *
Name of Organisation/ Institution *
Address *
Mobile (s) number *
Office / Home number *
Skype Address *
African Gong Thematic Working Groups *
There are Four Thematic Working Groups in African Gong as follows:
By completing this Membership Application Form you are indicating that you would like to be added to our database to receive regular information and updates on African Gong and other network events and opportunities for Science Communication and Public Engagement activities and programmes, such as Conferences, Workshops, Careers information, Publications, Calls for Proposals, Project Collaboration Calls, Funding Opportunities, etc. *
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