R-Mentorship Training Registration Form
Select Training/Program:
Select
Women-focused R Mentorship Program (GH¢100)
Men-focused R Mentorship Program (GH¢100)
First Name:
Last Name:
Gender:
Select
Male
Female
Age Group:
Select
15-20
21-30
31-40
41-50
51-60
60+
Country:
Region:
Select
Other
Ahafo
Ashanti
Bono
Bono East
Central
Eastern
Greater Accra
North East
Northern
Oti
Savannah
Upper East
Upper West
Volta
Western
Western North
City/Location:
Phone Number:
WhatsApp No:
Email Address:
Highest academic qualification:
Select
PhD
Masters
Bachelor Degree
HND/Diploma
Other
Experience in R:
Select
Absolute beginner
Intermediate
Advanced
Are you a member of any R-group/Community?
Select
Yes
No
State R-Group/Community (If Yes):
Comments or Suggestions:
What is 9 + 8?:
Continue to payment
