TELTA Membership form

First Name *

Second Name *

Last Name *

Gender *

Male Female Other

Email

Phone Number *

Preferred mode of communication *

SMS Only

WhatsApp

Mail

Phone Call

Other

Name of Institution/ School *

Job Type

Full time

Part time

Student

Job category

Primary School Secondary School University/Lecture/Professor Others

Level of Education *

PhD Masters Bachelor Diploma Certificate Other

Country *

Select a Country

Region *

District *

Explain briefly why do you want to become the TELTA Member *

Submit