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We kindly invite applications from institutions in eligible countries.
We suggest that you prepare the following information before filling out the application:
- Description of your institution and program
- Telephone numbers of responsible person(s)
- Planned quantities of products requested
- Logistics and distribution process
If you have a slow connection...
You can click here to download the application from in Word (249 KB).
The form can be completed at your computer or printed and filled out by hand.
Or contact us by email at DiflucanPartnership@AccessToTreatment.org
Please indicate your name, institution, and telephone number. We will return the application to you by e-mail and establish a telephone contact.
If you have access to a high-speed connection...
You can complete the form directly online by clicking here.
Our offices in France and Uganda are open Monday to Friday, 9AM to 5PM.
Paris
Phone: +331 44 860 760
Fax: +331 44 860 122
Kampala
Phone: +256 31 263 475
Fax: +256 41 340 642
If you would like us to call you, please indicate your name, institution, and telephone number in an email to us: DiflucanPartnership@AccessToTreatment.org
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