MEMBERSHIP FORM - Individual Members

Surname:
Forenames:
ID/Passport No:
Mailing Address:
Telephone:
Fax:
E-mail address:
Professional Background/Qualifications
Area of special interest in Health and Development
Amount to be paid: Kshs. or USD

Note: Membership Certificate shall be issued on payment of membership fees.
 

KISUMU - The Director, TICH in Africa, P.O. Box 2224, Kisumu, Telephone, 057-2023972/2024871,
Email: academics@tichafrica.org or adminkisumu@tichafrica.org
NAIROBI - P. O. Box 60827 - 00200, Nairobi, Telephone, 020- 576804, Email: tichnbi@wananchi.com