MAPPING OF CIVIL SOCIETY ORGANIZATIONS -  MEMBERS OF COUNTRY COORDINATING MECHANISMS (CCM) MALARIA
Sign in to Google to save your progress. Learn more
1. Your first and last names *
2. Your country *
3. Your organization *
4. Your email address *
5. Your WhatsApp phone number (with country code) *
6. Your position in the organization *
7. Are you a member of the Country Coordinating Mechanism (CCM) Malaria in your country? *
8. If YES, specify if you are a principal or substitute member? *
9. If you are a Principal Member, please provide the name of the Substitute Organization (with Name, phone and email address of the Manager)
10. If you are a Substitute Member, please provide the name of the Principal Organization (with Name, phone and email address of the Manager)
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of impact Sante Afrique. Report Abuse