Health Science Research Center Training Request Form

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Training Title :

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Subspecialty :

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Training Number of Day(s) :

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Credit Hours Requested :

(Only time spent in educational activities may be counted including discussions; please exclude time for breaks, lunch, etc.)

Language :

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Arabic

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Both Arabic and English

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Target Audience :

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PNU health sciences Faculty members

KAAUH clinical staff

PNU health sciences Students

Open to all interested researchers internally and externally

Others

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Preferred term(s) in which the training will be offered :

1st Academic Semester

2nd Academic Semester

Summer Semester

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Preferred Date :

D-M-Y

( Selected Date is not guaranteed, due to other HSRC commitments and logistics preparations.)

Will there be an exam for this training :

Yes

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If No, how to measure the participant understanding :

Prerequisite(s) or restriction(s) :

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Are there any resources required (library, audio-visual, lab equipment, lab space, etc.) ?

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(Our Auditorium/ and all workshop rooms are prepared with Projector and Internet)

Number of Speakers :

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Expected Number of Attendees :

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Training Description :

Total cost :

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Suggested cost per attendee :

Training Objectives :

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Please upload the training time table as word document.

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First Name :

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Father Name :

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No. of Speaking Hours :

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Nationality :

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Gender :

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City of Residence :

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Tel.:

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Email :

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Date :

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D-M-Y

School :

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Specialty :

Date :

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School :

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Specialty :

Date :

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School :

Place :

1. Title

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Date :

D-M-Y

2. Title

Place :

Date :

D-M-Y

No. of Scientific Participations :

No. of Scientific Publications :

Do you have SCFHS license?

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Yes

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Your SCFHS registration number :

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Date of Expiry :

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D-M-Y

Your ID number (Saudi National ID, Eqama or Passport).

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Date of Expiry :

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D-M-Y

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/^((02([-\/])29\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1[012])([-\/])(0[1-9]|1\d|2[0-8]))|((0[13-9]|1[012])([-\/])(29|30))|((0[13578]|1[02])([-\/])31))(\11|\15|\19)\d{4}))$/

/^(((\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00))([-\/])02(\6)29)|(\d{4}([-\/])((0[1-9]|1[012])(\9)(0[1-9]|1\d|2[0-8])|((0[13-9]|1[012])(\9)(29|30))|((0[13578]|1[02])(\9)31))))$/

/^(((\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00))([-\/])02(\6)29)|(\d{4}([-\/])((0[1-9]|1[012])(\9)(0[1-9]|1\d|2[0-8])|((0[13-9]|1[012])(\9)(29|30))|((0[13578]|1[02])(\9)31)))) (\d|[0-1]\d|[2][0-3]):[0-5]\d$/

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/^-?\d+,\d$/

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/^-?\d+,\d{2}$/

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