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HIV Counseling to Testing Training (HCtT)
Registration Form
HCtT Batch 15
Positive Action Foundation Philippines., Inc.
Location: 2613 Dian St. Malate, Manila.
Title
Mr.
Ms.
Mrs.
Dr.
Atty.
Prof.
Last Name
*
First Name
*
Middle Initial
*
Name of Organization
*
Email
*
Mobile Number
*
Phone Number
(Please include area code)
Fax Number
(Please include area code)
Nickname
Sex
Male
Female
Position / Designation
*
Religion
Website
Mailling Address
Briefly describe the programs of your organization
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Reminders:
All fields with asterisk are required
Please indicate your
title, complete name and designation
for the issuance of certificate.
Please refrain from bringing your car as there is no parking in the area.
If you have problem with online registration, you can also
download our form here
.