Cancer Research Symposium

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Registration Form

1
Profile
2
Occupation
3
Abstracts
4
Payment
5
Submission
6
Last Page
Your Profile
Please provide a few details about yourself
Your Title *
Surname *
First Name *
Last Name
Email Address *
Enter a valid email we will use to contact you for the purposes of the conference
Phone number *
Enter your phone number starting with your country code
Nationality *
Your Occupation/profession
Enter details about your profession
What is your highest level of education qualification? *
Please provide the title of your qualification *
E.g. BSc in Oncology
Are you currently an ongoing student? *
Enter the name of your educational institution *
What is the level of your studies *
Are you currently Employed/engaged in cancer research Programs *
Provide the name of your institution (Optional)
Abstracts
This section is for those who would like to present an abstract for a speaker/poster presentation.
Would you like to submit an abstract for speaker/poster/workshop presentation? *
Select the type of presentation *
What is the title of your presentation *
upload abstract 2
Maximum file size: 100 MB
Please ensure your upload is in a .docx (Ms Word) or .pdf(PDF) file format. Ensure your file has a similar title to the title provided in the previous question. Upload an abstract
payment details
After paying your registration fee, kindly email us the transaction details for verification on our end

All payments should be directed to the following account number below. You can pay either using a bank transfer, MPESA Paybill, or direct debit. Cash payments are not allowed. 

FOR BANK TRANSFER OR Direct debit, KINDLY USE THE DETAILS BELOW:

Account Name: INTEGRATED CANCER RESEARCH FOUNDATION OF KENYA

Bank: Kenya Commercial Bank

Branch: Moi Avenue, Kencom House Nairobi

Bank Account No:  1285887883 

SWIFT: KCBLKENX

FOR MPESA PAYMENT, KINDLY USE THE DETAILS BELOW:

Go To MPESA Paybill Option 

Enter KCB Paybill Number: 522522

Enter Account Details: 1285887883

Enter Amount: XXXXX

SUBMIT THE PAYMENT

After paying your registration fee, kindly email us the transaction details for verification on our end. After confirmation, we will send you an acknowlegment email.  

Your Privacy
By submitting this form, you agree that ICRF will use your personal data for the sole purpose of communication during the symposium *
Your SIGNATURE *
Type your full name in CAPS