Membership of ICOMAA, Canada

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Membership of ICOMAA, Canada

Membership of ICOMAA, Canada, as with ICOMAA, worldwide is open to former students of the University College/University of Ibadan:

Who were registered for any undergraduate course in the Faculty of Medicine/College of Medicine and Who by virtue of that registration, actually matriculated and successfully completed their program in the University.

You must be resident in Canada for membership in ICOMAA, Canada

Fields marked with an * are required

Personal Information

Membership Personal Information

Membership Type *

Salutation *

First Name *

Other Name

Last Name *

Surname at Graduation *

Email Address *

Phone Number *

Sex *

Address 1 *

Address 2 *

City *

Province *

Postal Code *

Country *

School INFORMATION

What year did you gain admission? *

What is your matriculation number? (Optional)

What year did you graduate? *

What program did you graduate from? *

SPECIALTY INFORMATION

Specialty *

Sub Specialty

Type of Practice *

REFERENCES INFORMATION

References (should be classmates resident in North America) *

Reference First Name

Reference Last Name

Reference Phone Number

Reference Email Address

Reference Location

CREATE MEMBERSHIP ACCOUNT

Email Address

Password

By checking this box I understand that my membership registration is not valid until my membership status is verified and payment is received *