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SAUDI HEART ASSOCIATION
Course Registration Form

PARTICIPANT DETAILS
Full Name
Contact Number
Nationality
resident / Iqama ID Number
Profession
Company / Organization
COURSE DETAILS
Registered Course
New / Renew
Starting Date
Ending Date
Time
SHA ACCOUNT DETAILS
Username
Password
Participant ID
PAYMENT DETAILS
Payment Date
Cash
POS
Bank Transfer
SHA (Portal) SADAD Payment
INSTRUCTOR NAME

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