International Individual Membership

Personal Details

PERSONAL DETAILS

Surname

Other Names

Phone Numbers

Nationality

Physical Address

Street Address

City

Country

Profession

Job Title

Specialty

Institution Name

Social Media

SOCIAL MEDIA CONNECTION

Please share your social media handles to connect with other AFREhealth members

Facebook Link / User Name

Twitter User Name

Instagram User Name

LinkedIn Link / User Name

Access Credentials

LOGIN DETAILS

Email Address

Password

Confirm Password

Interest / Expertise

Please indicate your area of expertise and what services you can render to AH? Examples are but not limited to: Mentorship, External Examiner, Publication reviewer, grant writing, proposal development