OSS TEST

Full Name *(First and Last Name)

Phone *

Email Address *

Gender *MaleFemale

Occupation *Medical studentNurseGFPMedical OfficerResidentRegistrarConsultantOther

Occupation *

Speciality *

Hospital / Institution *

Are you a current OMA member ? (medical students and nurses are not required to be members to OMA, but they MUST be members to OSS ) *YesNo

Are you a current member of OSS ?YesNo

If you a current member to OSS, kindly enter your 5- digits OSS registration number (a unique number was sent to all members) *

Date of joining OSS: *

m/d/y