Register for NISA 2019

 

Welcome to NISA 2019! Please register below.

Registration cannot be completed without making a payment of ₦35,000 per individual.

1. Please make payment to Sterling Bank

BANK NAME: Sterling Bank

ACCOUNT NUMBER:

Naira: 0069494256

Dollars: 0071367632

Sort Code: 232080021

NAME ON ACCOUNT: Impacting Lives, Nigerian Implementation Science Association

2. Send email to nisa.assistant1@gmail.com if no response send an email to nisa.research@gmail.com with proof payment

3. Please allow 48 hours for payment to be processed.

4. Once payment is confirmed you will receive a registration pin needed to complete registration form.

5. Once you receive your pin continue to complete the registration form below

Early Registration: ₦35,000; Late Registration: ₦50,000;  Onsite Registration ₦75,000

SEATING IS LIMITED!

 
Name *
Name
Enter your First Name and Last (Family) Name.
Have you made a payment to NISA account? *
Registration cannot be finalized until the payment is made.
Type of registration *
BANK NAME: Sterling Bank ACCOUNT NUMBER: Naira: 0069494256 Dollars: 0071367632 Sort Code: 232080021 NAME ON ACCOUNT: Impacting Lives, Nigerian Implementation Science Association
Phone Number *
Phone Number
Gender *
For example, MBBS, MD, MPH, PhD, BS, BSc
Which SINGLE area do you identify yourself with the most? *
What is your SINGLE primary area of interest for Implementation Science? *
Did you attend NISA in the past? *
Do you plan to submit an abstract for NISA 2019? *
Would you like to attend NISA workshops focused on research skills and implementation science throughout the year? *
Would you be willing to pay for the workshops? *
Outside of training for your first (Bachelors’) degree, how many years of research experience do you have? *
Experience during medical school counts as part of research training.
Do you have at least one post graduate degree? *
For example, Masters, MBBS, MBChB, MD, PhD?
What is/ are your post graduate degrees in? *
Check all that apply.
In what country did you obtain your postgraduate degree in? *
How many publications do you have? *
Will you be attending Gala Night on September 19th? *