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Home
About SAMA
Join SAMA
Membership Application
Annual Meeting 2012
SAMA Humanitarian
SAMA E-clinic
SAMA Visiting Faculty Program
Medical Training in USA
Dental training in USA
SAMA News & Updates
Forum
Links
Contact Us
Donate
Visiting Faculty Program Application form
First Name
(required)
Last Name
(required)
Specialty
(required)
Grade (Attending or Fellow)
(required)
Institution
(required)
Email Address
(valid email required)
City
(required)
State
(required)
Country
(required)
Mobile Phone
(required)
Phone in Sudan (if available)
Your involvement
Visit Sudan and participate in educational activities
Not Visiting Sudan but can help in preparing educational activities for other Visiting Faculty
None of the above
Month of availability in Sudan (select all that apply)
November 2011
December 2011
January 2012
February 2012
March 2012
April 2012
May 2012
June 2012
July 2012
August 2012
September 2012
Choice of activity
Lecture/tutorial
Conference workshop/Course
Hands on training (Procedures/Surgery)
cforms
contact form by delicious:days
