First BA Regional Workshop on the Epidemiology of
Diabetes & Other Non-Communicable Diseases
5-13 January 2009
* Title * First Name
Middle Name * Last Name
* Sex
* Date or Birth / /
* Nationality * Email
* Address
* Telephone Fax
* Organization * Job Title
* Educational background
Research experience
Previous exposure to Epidemiology and Biostatistics courses

(If yes, please mention the courses that you attended and the statistics packages that you are familiar with)
* Why do you want to attend this workshop?
(at least 100 words)
* Future plan (with respect to research)
* How did you learn about this workshop?
* CV
*THE ITEMS MARKED WITH ASTERISK ARE MANDATORY