en
fr
Get in touch

Nominations

Back to home




Thanks for visiting us! West African Clinical Alliance Awards has Opened!



DETAILS OF NOMINATOR



Nominator Full Name: *
Nominator Phone Number: *
Nominator Email: *
PROFESSION / RANK / INSTITUTION : *
RESAON FOR NOMINATION :




NOMINEE DETAILS



Nominee Name
Nominee Phone: *
Nominee Email: *
WEBSITE (IF ANY)
Categories: *
NAME of MEDICAL DIRECTOR/CEO
SPECIALITY
ACHIEVEMENT/PROGRESS BETWEEN 2018/2019 IN TERMS OF
Please provide a Profile about the nominee's work history and career achievements. It is ok if you don't have all the details but be as thorough as possible:

Upload a Logo/Portrait picture of nominee (High Resolution):*
Close