تعبئة الاستمارة - نقابة الاختصاصيين في علم التغذية وتنظيم الوجبات في لبنان

تعبئة الاستمارة

Full Name

Address

Phone

Preferred email for correspondence

Home address governate

Get your university nutrition/dietetics degree from

If you have not obtained your nutrition/dietetics degree from any of the above universities, please write the name of the university you graduated from.

DOB

Have you passed the Lebanese colloquium?

Which of the following best describes your job

Current Job Title

Highest level of education you received

Do we have your consent to share your name and email on our website and with suitable third parties?

Address of Work

Do you have a license to practice issued by the MPH

Name of work institution/place of work

If you have degrees other than a nutrition degree, please provide a summary of your academic degrees and university of graduation