Membership Registration Form

Membership Category

Student Member (Annual) Individual Member (Annual) Individual Member (Lifetime) Institutional Member

Applicant Information - Individual

Full Name *

Date of Birth

Gender

Profession/Cadre

Current Place of Work/Institution

Position/Title

Phone Number *

Email Address *

District/City of Residence *

Applicant Information - Institutional

Institution Name *

Type of Institution

Contact Person *

Designation

Phone Number *

Email Address *

Physical Address

District/City *

Areas of Interest

CME/CPD Research and Publications Public Health Health Systems Strengthening Digital Health & E-Learning Community Health Advocacy & Policy Partnerships & Networking

Declaration

I confirm that the information provided is correct and I agree to uphold the values, objectives, and policies of Busoga Health Forum.

Register Now to become a BHF Member

BUSOGA HEALTH FORUM (BHF) MEMBERSHIP REGISTRATION

Membership Category

Applicant Information - Individual

Applicant Information - Institutional

Areas of Interest

Declaration