{"id":19970,"date":"2025-10-11T12:44:00","date_gmt":"2025-10-11T12:44:00","guid":{"rendered":"https:\/\/imagedoctors.org\/?page_id=19970"},"modified":"2025-12-01T19:11:01","modified_gmt":"2025-12-01T19:11:01","slug":"registration-annual-national-conference","status":"publish","type":"page","link":"https:\/\/imagedoctors.org\/index.php\/registration-annual-national-conference\/","title":{"rendered":"Registration form- CMDA Tz Annual National Conference"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"19970\" class=\"elementor elementor-19970\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-9062c8c e-flex e-con-boxed e-con e-parent\" data-id=\"9062c8c\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-99a6378 elementor-widget elementor-widget-image\" data-id=\"99a6378\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.23.0 - 15-07-2024 *\/\n.elementor-widget-image{text-align:center}.elementor-widget-image a{display:inline-block}.elementor-widget-image a img[src$=\".svg\"]{width:48px}.elementor-widget-image img{vertical-align:middle;display:inline-block}<\/style>\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"980\" height=\"616\" src=\"https:\/\/imagedoctors.org\/wp-content\/uploads\/2025\/11\/fdfdg-1024x644.png\" class=\"attachment-large size-large wp-image-20038\" alt=\"\" srcset=\"https:\/\/imagedoctors.org\/wp-content\/uploads\/2025\/11\/fdfdg-1024x644.png 1024w, https:\/\/imagedoctors.org\/wp-content\/uploads\/2025\/11\/fdfdg-300x189.png 300w, https:\/\/imagedoctors.org\/wp-content\/uploads\/2025\/11\/fdfdg-768x483.png 768w, https:\/\/imagedoctors.org\/wp-content\/uploads\/2025\/11\/fdfdg-1536x966.png 1536w, https:\/\/imagedoctors.org\/wp-content\/uploads\/2025\/11\/fdfdg-2048x1289.png 2048w\" sizes=\"(max-width: 980px) 100vw, 980px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b2b0229 elementor-widget elementor-widget-text-editor\" data-id=\"b2b0229\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.23.0 - 15-07-2024 *\/\n.elementor-widget-text-editor.elementor-drop-cap-view-stacked .elementor-drop-cap{background-color:#69727d;color:#fff}.elementor-widget-text-editor.elementor-drop-cap-view-framed .elementor-drop-cap{color:#69727d;border:3px solid;background-color:transparent}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap{margin-top:8px}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap-letter{width:1em;height:1em}.elementor-widget-text-editor .elementor-drop-cap{float:left;text-align:center;line-height:1;font-size:50px}.elementor-widget-text-editor .elementor-drop-cap-letter{display:inline-block}<\/style>\t\t\t\t<p><b>Welcome to the Christian Medical and Dental Association of Tanzania Annual National Conference, A VIRTUAL CONFERENCE TO BE HELD ON 13th December 2025.&nbsp;<\/b><\/p>\n<div>\n<div style=\"color: red;\"><b><i>Kindly note that your registration will be considered only after payment.<\/i><\/b><\/div>\n<div style=\"color: red;\">\n<table style=\"border: 1px; border-color: red;\" cellspacing=\"0\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td valign=\"top\">\n<p style=\"font-style: normal; font-variant-caps: normal; font-width: normal; font-size: 12px; line-height: normal; font-family: Helvetica; font-size-adjust: none; font-kerning: auto; font-variant-alternates: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-position: normal; font-variant-emoji: normal; font-feature-settings: normal; font-optical-sizing: auto; font-variation-settings: normal;\">Students<\/p>\n<\/td>\n<td valign=\"top\">\n<p style=\"font-style: normal; font-variant-caps: normal; font-width: normal; font-size: 12px; line-height: normal; font-family: Helvetica; font-size-adjust: none; font-kerning: auto; font-variant-alternates: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-position: normal; font-variant-emoji: normal; font-feature-settings: normal; font-optical-sizing: auto; font-variation-settings: normal;\">5,000\/-<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\">\n<p style=\"font-style: normal; font-variant-caps: normal; font-width: normal; font-size: 12px; line-height: normal; font-family: Helvetica; font-size-adjust: none; font-kerning: auto; font-variant-alternates: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-position: normal; font-variant-emoji: normal; font-feature-settings: normal; font-optical-sizing: auto; font-variation-settings: normal;\">Juniors<\/p>\n<\/td>\n<td valign=\"top\">\n<p style=\"font-style: normal; font-variant-caps: normal; font-width: normal; font-size: 12px; line-height: normal; font-family: Helvetica; font-size-adjust: none; font-kerning: auto; font-variant-alternates: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-position: normal; font-variant-emoji: normal; font-feature-settings: normal; font-optical-sizing: auto; font-variation-settings: normal;\">10,000\/-<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\">\n<p style=\"font-style: normal; font-variant-caps: normal; font-width: normal; font-size: 12px; line-height: normal; font-family: Helvetica; font-size-adjust: none; font-kerning: auto; font-variant-alternates: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-position: normal; font-variant-emoji: normal; font-feature-settings: normal; font-optical-sizing: auto; font-variation-settings: normal;\">Seniors<\/p>\n<\/td>\n<td valign=\"top\">\n<p style=\"font-style: normal; font-variant-caps: normal; font-width: normal; font-size: 12px; line-height: normal; font-family: Helvetica; font-size-adjust: none; font-kerning: auto; font-variant-alternates: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-position: normal; font-variant-emoji: normal; font-feature-settings: normal; font-optical-sizing: auto; font-variation-settings: normal;\">15,000\/-<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div style=\"color: red;\"><b><i>Pay via Mpesa Lipa no: 52727729. Account name: ImageDoctors Organization<\/i><\/b>.<\/div>\n<\/div>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9b6fa70 fluent-form-widget-step-header-yes fluent-form-widget-step-progressbar-yes fluentform-widget-submit-button-custom elementor-widget elementor-widget-fluent-form-widget\" data-id=\"9b6fa70\" data-element_type=\"widget\" data-widget_type=\"fluent-form-widget.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\n            <div class=\"fluentform-widget-wrapper fluentform-widget-align-default\">\n\n            \n            <div class='fluentform ff-inherit-theme-style fluentform_wrapper_3'><form data-form_id=\"3\" id=\"fluentform_3\" class=\"frm-fluent-form fluent_form_3 ff-el-form-top ff_form_instance_3_1 ff-form-loading ffs_inherit_theme\" data-form_instance=\"ff_form_instance_3_1\" method=\"POST\" ><fieldset  style=\"border: none!important;margin: 0!important;padding: 0!important;background-color: transparent!important;box-shadow: none!important;outline: none!important; min-inline-size: 100%;\">\n                    <legend class=\"ff_screen_reader_title\" style=\"display: block; margin: 0!important;padding: 0!important;height: 0!important;text-indent: -999999px;width: 0!important;overflow:hidden;\">CMDA Tanzania - Annual National Conference<\/legend><input type='hidden' name='__fluent_form_embded_post_id' value='19970' \/><input type=\"hidden\" id=\"_fluentform_3_fluentformnonce\" name=\"_fluentform_3_fluentformnonce\" value=\"b944349e5a\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php\/wp-json\/wp\/v2\/pages\/19970\" \/><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_full_name' >Your full name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"full_name\" class=\"ff-el-form-control\" placeholder=\"Your full name\" data-name=\"full_name\" id=\"ff_3_full_name\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"What are you doing?\">What are you doing?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=profession_level_c6e44aff7a63a707c63c310871039d8b><input  type=\"radio\" name=\"profession_level\" data-name=\"profession_level\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"student\"  id='profession_level_c6e44aff7a63a707c63c310871039d8b' aria-label='Student (Certificate, Diploma and Undergraduate only)' aria-invalid='false' aria-required=true> <span>Student (Certificate, Diploma and Undergraduate only)<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=profession_level_2125801aadac6c9fe84611b073cff400><input  type=\"radio\" name=\"profession_level\" data-name=\"profession_level\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"junior_professional\"  id='profession_level_2125801aadac6c9fe84611b073cff400' aria-label='Junior Professional(all professionals with certificate, diploma or undergraduate qualification)' aria-invalid='false' aria-required=true> <span>Junior Professional(all professionals with certificate, diploma or undergraduate qualification)<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=profession_level_e4b8120cffd482007bca381fb7bf8782><input  type=\"radio\" name=\"profession_level\" data-name=\"profession_level\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"senior_professional\"  id='profession_level_e4b8120cffd482007bca381fb7bf8782' aria-label='Senior Professional(all professionals with masters degree, super speciality or Phd)' aria-invalid='false' aria-required=true> <span>Senior Professional(all professionals with masters degree, super speciality or Phd)<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_institution_name' >What is the name of your institution?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"institution_name\" class=\"ff-el-form-control\" placeholder=\"eg Muhimbili University of Applied Sciences\" data-name=\"institution_name\" id=\"ff_3_institution_name\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_field_of_study' aria-label=\"What is your field of work\/study?\">What is your field of work\/study?<\/label><\/div><div class='ff-el-input--content'><select name=\"field_of_study\" id=\"ff_3_field_of_study\" class=\"ff-el-form-control\" data-name=\"field_of_study\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=true><option value=\"\">- Select -<\/option><option value=\"medicine\"  >Medicine<\/option><option value=\"pharmacy\"  >Pharmacy<\/option><option value=\"laboratory_science\"  >Laboratory Science<\/option><option value=\"nursing\"  >Nursing<\/option><option value=\"physiotherapy\"  >Physiotherapy<\/option><option value=\"occupational_therapy\"  >Occupational Therapy<\/option><option value=\"optometry\"  >Optometry<\/option><option value=\"other\"  >Other<\/option><\/select><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_other_field' aria-label=\"Other: Specify\">Other: Specify<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"other_field\" class=\"ff-el-form-control\" placeholder=\"Specify\" data-name=\"other_field\" id=\"ff_3_other_field\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_email_address' aria-label=\"Please provide your email address\">Please provide your email address<\/label><\/div><div class='ff-el-input--content'><input type=\"email\" name=\"email_address\" id=\"ff_3_email_address\" class=\"ff-el-form-control\" placeholder=\"eg john@example.com\" data-name=\"email_address\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_whatsapp_number' aria-label=\"Please provide your phone number that can be contacted in WhatsApp\">Please provide your phone number that can be contacted in WhatsApp<\/label><\/div><div class='ff-el-input--content'><input name=\"whatsapp_number\" class=\"ff-el-form-control ff-el-phone ff_el_with_extended_validation\" type=\"tel\" placeholder=\"7XXX XXX XX\" data-name=\"whatsapp_number\" id=\"ff_3_whatsapp_number\" inputmode=\"tel\"  aria-invalid='false' aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"Is this your first ICMDA event to attend?\">Is this your first ICMDA event to attend?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=first_icmda_event_a97311aeaa1e33025c79fc3b25081052><input  type=\"radio\" name=\"first_icmda_event\" data-name=\"first_icmda_event\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"yes\"  id='first_icmda_event_a97311aeaa1e33025c79fc3b25081052' aria-label='Yes' aria-invalid='false' aria-required=true> <span>Yes<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=first_icmda_event_a7d3a9ff5e8a0c6eb82a45a3e1b4cb07><input  type=\"radio\" name=\"first_icmda_event\" data-name=\"first_icmda_event\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"no\"  id='first_icmda_event_a7d3a9ff5e8a0c6eb82a45a3e1b4cb07' aria-label='No' aria-invalid='false' aria-required=true> <span>No<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_previous_events' aria-label=\"Please specify events you have attended\">Please specify events you have attended<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"previous_events\" class=\"ff-el-form-control\" placeholder=\"Please specify events you have attended\" data-name=\"previous_events\" id=\"ff_3_previous_events\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group  ff-dropzone'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_image-upload_1' aria-label=\"Please Upload a Proof of Payment\">Please Upload a Proof of Payment <\/label><\/div><div class='ff-el-input--content'><label for='ff_3_image-upload_1' class='ff_file_upload_holder'><span class='ff_upload_btn ff-btn' tabindex='0'>Choose File (eg A Picture of Payment Message)<\/span> <input type=\"file\" name=\"image-upload\" id=\"ff_3_image-upload_1\" class=\"ff-el-form-control  ff-screen-reader-element\" accept=\"image\/*\" data-name=\"image-upload\" multiple=\"1\"  aria-invalid='false' aria-required=true><\/label><\/div><\/div><div class='ff-el-group ff-text-left ff_submit_btn_wrapper ff_submit_btn_wrapper_custom'><button class=\"ff-btn ff-btn-submit ff-btn-md ff_btn_style wpf_has_custom_css\" type=\"submit\" name=\"custom_submit_button-3_1\" data-name=\"custom_submit_button-3_1\" >Submit<\/button><style>form.fluent_form_3 .wpf_has_custom_css.ff-btn-submit { background-color:#1a7efb;border-color:#1a7efb;color:#ffffff; }form.fluent_form_3 .wpf_has_custom_css.ff-btn-submit:hover { background-color:#ffffff;border-color:#1a7efb;color:#1a7efb;min-width:100%; } <\/style><\/div><\/fieldset><\/form><div id='fluentform_3_errors' class='ff-errors-in-stack ff_form_instance_3_1 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Students 5,000\/- Juniors 10,000\/- Seniors 15,000\/- Pay via Mpesa Lipa no: 52727729. Account name: ImageDoctors Organization. CMDA Tanzania &#8211; Annual National [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_seopress_robots_primary_cat":"","_seopress_titles_title":"","_seopress_titles_desc":"","_seopress_robots_index":"","inline_featured_image":false,"footnotes":""},"class_list":["post-19970","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/imagedoctors.org\/index.php\/wp-json\/wp\/v2\/pages\/19970","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/imagedoctors.org\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/imagedoctors.org\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/imagedoctors.org\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/imagedoctors.org\/index.php\/wp-json\/wp\/v2\/comments?post=19970"}],"version-history":[{"count":59,"href":"https:\/\/imagedoctors.org\/index.php\/wp-json\/wp\/v2\/pages\/19970\/revisions"}],"predecessor-version":[{"id":20054,"href":"https:\/\/imagedoctors.org\/index.php\/wp-json\/wp\/v2\/pages\/19970\/revisions\/20054"}],"wp:attachment":[{"href":"https:\/\/imagedoctors.org\/index.php\/wp-json\/wp\/v2\/media?parent=19970"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}