Workshop Registration

Workshop Registration Form

"*" indicates required fields

Basic Information

Title:*

First Name:*

Last Name:*

Department*

Email*

Email OTP*

Position*

Badge No*

Extension*

Mobile No

Saudi Council ID Number

Mail Code

Gender*

Male

Female

Category*

Administration*

if other specify category

if other specify administration

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Department's Head Name & Email

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Head Name

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Head Email (KSAU-HS or NGHA Email)

Workshop Details

Workshop Title:*

Date:

Date:

Date:

Date:

Date:

Date:

Date:

Date:

Date:

Date:

Date:

Date:

Date:

Date:

Date:

Date:

Date:

Date:

Date:

Date:

From:

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From:

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From:

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From:

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To:

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To:

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To:

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Terms & Regulations

Applicants will be informed with approval / disapproval before workshop conduction.
Approved participants should be fully free from duty commitments during the hours of the training.
Department Head approval is required.
In case that the approved participant is unable to attend the workshop for any circumstances, the organizer must be informed on time to give the slot to others.
Note: Your request will be sent to your Department’s Head and during the leave of absence, please add the designee's name and email address.
For any inquiries or questions, please contact Ms. Amal Shutaywi Department of Medical Education Email: COMJ-MedEd@NGHA.MED.SA, Ext: 45854.
By submitting this form, you agree to the terms and regulations.

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