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The World Innovation Summit for Health (WISH) has made a limited number of delegate places available to partners and stakeholders on a complimentary basis. In addition, we invite all other interested parties to apply to WISH2018, which will be subject to a registration fee of 200 QAR.

Following the receipt of your application, our logistics team will be happy to contact you with further information and payment instructions.

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MaleFemale
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[md-select label="Title"]
---Mr.Mrs.MsDr.ProfessorAmbassadorDameLadyLordSheikhSheikhaSir
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[md-text label="First Name"]

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[md-text label="Last Name"]

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[md-select label="Nationality"]
---AfghanAlbanianAlgerianAmericanAndorranAngolanAntarticaAntiguansArgentineanArmenianAustralianAustrianAzerbaijaniBahamianBahrainiBangladeshiBarbadianBelarusianBelgianBelizeanBenineseBhutaneseBirmanBolivianBosnianBrazilianBritishBruneianBulgarianBurkinabeBurmeseBurundianCambodianCameroonianCanadianCape VerdianCaymanianCentral AfricanChadianChileanChineseColombianComoranCosta RicanCroatianCubanCypriotCzechDanishDemocratic Republic of the CongoDjiboutiDominicaDominicanDutchEcuadoreanEgyptianEmiratiEquatorial GuineanEritreanEstonianEthiopianFaroeseFijianFilipinoFinnishFrenchGaboneseGambianGeorgianGermanGhanaianGreekGrenadianGuatemalanGuinea-BissauanGuineanGuyaneseHaitianHonduranHong KongHungarianI-KiribatiIcelanderIndianIndonesianIranianIraqiIrishIsraeliItalianIvorianJamaicanJapaneseJordanianKazakhstaniKenyanKittianKosovarKuwaitiKyrgyzLaotianLatvianLebaneseLiberianLibyanLiechtensteinerLithuanianLuxembourgerMacedonianMalagasyMalawianMalaysianMaldivanMalianMalteseMarshalleseMauritanianMauritianMexicanMicronesianMoldovanMonegasqueMongolianMontenegrinMoroccanMosothoMotswanaMozambicanNamibianNauruanNepaleseNew ZealanderNicaraguanNigerianNigerienNorth KoreanNorwegianOmaniPakistaniPalauanPalestinianPanamanianPapua New GuineanParaguayanPeruvianPolishPortuguesePuerto RicanQatariRepublic of the CongoRomanianRussianRwandanSaint LucianSaint VincentianSalvadoranSammarineseSamoanSao TomeanSaudi ArabianSenegaleseSerbianSeychelloisSierra LeoneanSingaporeanSlovakianSlovenianSolomon IslanderSomaliSouth AfricanSouth KoreanSouth SudaneseSpanishSri LankanSudaneseSurinamerSwaziSwedishSwissSyrianTaiwaneseTajikTanzanianThaiTimoreseTogoleseTonganTrinidadianTunisianTurkishTurkmenTuvaluanUgandanUkrainianUnited NationsUruguayanUzbekVanuatanVaticanVenezuelanVietnameseWestern SaharaYemeniteZambianZimbabwean
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[md-text label="Organization"]

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[md-text label="Link to organization website"]

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[md-text label="Position"]

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[md-text label="Your email"]

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[md-text label="Assistant email"]

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[md-text label="Phone"]

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[md-select label="Sector"]
---AcademiaGovernmentGovernment agencyHealthcare providerCommercialMediaMulti-lateral organizationNGO/CharityTechnologyOther
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[md-select label="How did you originally hear about the opportunity to attend WISH?"]
---WISH websiteSocial mediaOnline ad – bannerColleagues and network: forwarded emailPressPartner organizationSearch engineEmail from WISHWord of mouth
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[md-radio label="Did you attend WISH before?"]
YesNo
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[md-textarea label="Biography"]
Biography (url to online biography or text)
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[md-textarea label="Your message"]

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[md-text label="Qatar ID / Resident Permit Number"]

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[md-radio label="I would like to subscribe to the WISH newsletter"]
YesNo
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