symposium registration

Symposium Registration Form
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  • Title:*(prof., Dr./ Mr./ Ms)
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  • Full Name:*
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  • Institution/ organization:*
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  • Position / Title:*
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  • Country:*
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  • Email Address:*
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  • University Name:*
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  • Direct Phone Number:*
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  • WhatsApp Number:*
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  • Participation Type:*
    In-person (Tehran)
    Online
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  • Network for Health & Peace (GNHP)?*Network for Health & Peace (GNHP)?
    Yes
    No
    Membership pending
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  • Preferred language of participation:*
    English
    Persian
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  • By submitting this form, I confirm my interest in attending the symposium and agree that my data may be used for official event coordination purposes in line with privacy regulations. Signature: _____________________   Date: ___________
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  • Date:*
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  • Submission: For assistance, please contact us via WhatsApp +98(915)8736277 or email Gsia@tums.ac.ir
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