African Stroke Organization (ASO) - Expression of Interest (Membership) Form
Welcome to the official membership registration portal of the African Stroke Organization (ASO). The African Stroke Organization is a pan – African society of stroke researchers, clinicians, other healthcare professionals, national and regional stroke societies and stroke support organizations (SSOs) with passion for stroke care, research, education and advocacy. In tandem with the vision of the World Stroke Organization (WSO), the vision of ASO is aimed at reducing the burden of stroke in Africa through multidisciplinary research and capacity building, promoting the development of effective stroke prevention and intervention services, enhancing stroke awareness, advocating for stroke survivors and their families/caregivers and driving the formulation of stroke - friendly policies across multiple levels of policy makers across African nations’. For continued communication and future planning, this form is created to capture details of persons who have expressed interest to affiliate/associate with this organization. Membership is open to all professionals (trainees; early, mid and advanced career researchers, etc.) who share in the vision statement of this noble organization. Your details will be handled with utmost confidentiality and will be used for the sole purpose of and within the remit of the ASO activities. Please feel free to share this link to and invite your various networks, professionals groups and Colleagues to become a member. Thank you so much for your expression of interest.
Name (Surname, in BLOCK, followed by other names)
Prefer not to say
Stroke Support Organization Member
Trainees (Msc, PhD, Resident, Internist etc.)
Type of Professional Practice
Years of Professional Practice
Contact details 1 [Functional telephone number(s)]
Contact details 2 [Functional email address(es)]
Are you affiliated with any Stroke Support Organization (SSO)
If Yes, please kindly state the SSO to which you are affiliated
Are you affiliated with any other organization(s)?
If Yes, please kindly state the additional organizations to which you are affiliated
Which of the following ASO work groups will you like to subscribe to?
Advocacy, Awareness, Collaboration and Empowerment
Funding and Sustainability
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service