Registration Procedure(NOTE: ALL FIELDS ARE REQUIRED TO BE FILLED)
Personal Details
TITLE
select an option
PROF
DR
MR
MRS
Ms
NAME
EMAIL
PLACE OF WORK
select an option
Public
Private
Student
COUNTRY CODE
TELEPHONE NUMBER (a valid whatsapp number)
AGE
select an Age range
20-30
30-39
40-49
50-59
60-69
70+
ADDRESS
PROFESSION
Select an option
Nurse/Midwife Practitioner
Nurse/Midwife Administrator
Nurse/Midwife Educator/Researcher
Nurse/Midwife Private Sector
Nurse/Midwife student NMTCs
Nurse/Midwife Student University
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Payment Details
STUDENT ID
(enter 0 if not student)
AMOUNT
DATE OF TRANSACTION
MOMO TRANSACTION ID
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