Short Courses Application Form

Please complete the form below:
Fields marked with a are mandatory.

Please select a Course

(If you wish to select more than one course then fill the form again)

How did you find out about the course?

Name:

Phone number:

Profession: Postal Address:

Your email:

Sponsorship Self-sponsorship Other

Please give details of sponsoring agent below:

Contact Firstname:
Contact Surname:
Sponsoring Agent:
Job Title:
Contact Postal Address:

Contact Email
Contact Telephone:
Contact Fax:
Other Information:
What do you expect to gain from the course:

AMREF will use the information you have provided on this form to respond to your enquiry/comment or to direct your enquiry/comment to an appropriate AMREF local office. We may also use the information to maintain future contact with you in order to send news of the latest AMREF activities. AMREF complies with the data protection laws in Kenya and takes all reasonable care to prevent any unauthorised access to your personal data. You agree to these terms and conditions by clicking the submit key below.

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AMREF Headquarters, Langata Road, P.O Box 27691 - 00506, Nairobi, Kenya

Tel: +254 20 6993000 Fax: +254 20 609518