If you have a
slow connection
You can either: download the application
form in Word (200 K)
Progress Reports
Shipping Sheet
The form can be completed at your computer or printed and
filled out by hand.
Or contact us by e-mail at
PMTCT@AccessToTreatment.org
Please indicate your name, institution, and
telephone number. We will return the form 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 on this link.
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You can facilitate
the application process by preparing
the following information before filling
out the application:
- Description of your institution
and/or program
- Telephone numbers of responsible
person(s)
- Planned quantities of products requested
- Description of your logistics and
distribution process
|
Contact Information
email: PMTCT@AccessToTreatment.org
Paris
Phone: +33 (0)1 44 860 760
Fax: +33 (0)1 44 860 122
Kampala
Phone: +256 312 264 475
or +256 414 340 807
Fax: +256 414 340 642
Postal address
PMTCT Donations Program
Axios International
7 Boulevard de la Madeleine
75001 Paris, France
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