Registration Form

1
2
Next Page
3
Last Page
section 1. Your profile
All fields marked * are mandatory.
SURNAME *
Enter your surname
FIRST NAME *
Enter your first name
LAST NAME
Enter your last name
EMAIL ADDRESS *
Enter a valid email address
YOUR PHONE NUMBER *
Enter your phone number starting with your country code
SECTION 2. workshop/speaker/poster presentation
This section is for those who would like to present an abstract for a workshop/speaker/poster presentation
WOULD YOU LIKE TO SUBMIT AN ABSTRACT FOR SPEAKER/POSTER OR WORKSHOP PRESENTATION? *
SELECT THE TYPE OF PRESENTATION
ENTER THE TITLE OF YOUR WORKSHOP *
SELECT THE CATEGORY OF YOUR PRESENTATION *
IF YOU HAVE SELECTED OTHER IN THE ABOVE FIELD, PLEASE Provide the category
ENTER THE TITLE OF YOUR PRESENTATION *
SELECT THE CATEGORY OF YOUR PRESENTATION *
IF YOU HAVE SELECTED OTHER IN THE ABOVE FIELD, PLEASE Provide the category
SECTION 3. PAYMENT INFORMATION
Payment can be done via Mpesa Paybill Number or by bank transer.

To pay via Mpesa, use the following details:

Mpesa Paybill Number: 522522

Account Number: 1285887883 

To pay via Bank Transfer, please use the following details:

ACCOUNT NAME: INTEGRATED CANCER RESEARCH FOUNDATION OF KENYA
BANK: KENYA COMMERCIAL BANK
BRANCH: MOI AVENUE, KENCOM HOUSE NAIROBI
BANK ACCOUNT NO:  1285887883 
SWIFT: KCBLKENX

Once you have made your payment, please send your MPESA Transaction Code/Bank Transaction Reference Number to symposium23@cancerresearchkenya.org. You will receive a payment confirmation email within 24 hours.
By submitting this form, you give ICRF permission to contact you and share with your more information about the symposium.