User information for ICAN web site

First and Last Name:

TEST MEMBER 

Initials of this user or institution:

XX 

E-Mail address of the user:

- 

Phone number of the user [format: (+country_code)(city_code)your_number ]:

 

Institution data:

Name:

 

Address:

 

Phone number [format: (+country_code)(city_code)your_number x extension ]:

 

E-Mail address:

 

WWW page address:

 

Institution Country:

 

Country:

Zimbabwe

Job Title:

 

Job Area/Department:

 

Length of time with employer:

 

Reason why you entered ICAN web site:

 

Introduce your self and your organization: