Organisation Location Registration

This information requested here relates to the individual completing this registration form. Your name and job title will be displayed on the individual location page attached to your Organisation. Your email address and secondary account contact will be kept private.

Choose your preferred form of address from the list

Please enter your personal name (forename)

Please enter your family name (surname)

Please enter any suffixes you wish to appear after your name – e.g. MD, PhD, FACS

Where possible, please use the email address assigned to you by your organisation – e.g. yourname@yourngo.org. This helps us verify your registration.

The phone number will only be visible to logged-in InterSurgeon members

The name chosen here will be how you are addressed in email communications – it will only be seen by you

If possible, please list another member of your team as a secondary account contact in case you are unavailable:

This information will be kept private and only used if we need to contact your organisation and are not able to reach you

This information will be kept private and only used if we need to contact your organisation and are not able to reach you. Ensure that you have permission to add this information. Where possible, use the email address assigned by your organisation – e.g. name@yourngo.org.

Please select a country from the list

Choose whichever best describes the activity

Please add a sentence or two to describe the purpose and activities of this location

If possible, please provide an address.

Please use the English language version of your address as shown in Google Maps. Enter the first line of the address here.

Please use the English language version of your address as shown in Google Maps. Enter the second line of the address here.

Please use the English language version of your address as shown in Google Maps. Enter the third line of the address here.

The city where this location is based.

The state, county or administrative zone of this location.

Please enter the ZIP or postcode for this location.

If the location shown isn’t correct, choose ’No’, then use the search field above the map to search for the correct location. Alternatively, drag the marker to the correct location.

Location map

The marker here shows your location. If it’s not quite right, drag it to the correct place. If you have entered an address above, that will not be affected.

The location name given here will be shown in your NGO's account for internal use only. Please keep it simple and descriptive – e.g. Nairobi Office