REGISTRATION
Please fill in the registration form below: All fields are mandatory.
Last Name:
  
(Please incl. Prof / Dr / Ms / Mr)
First Name:
  
Positon:
  
Institution / Museum:
  
Postal Address:
City:
  
Post Code:
  
Country:
  
Telephone:
  
(Please indicate country and city codes)
Mobile:
  
Fax:
  
Email:
  
Passport number:
  
Passport expiry date:
 Date Month Year
Registration Payments:
Early Bird
before 30th September 2009
After 30th September 2009
& on-site
Number
of persons
AFRICOM Members
Includes breaks, registration materials, social / cultural events, excursion
  
Please also select from the box below the number of accompanying persons, if applicable
US$75
US$150
Non - Members
US$150
US$250
Accompanying Person(s)
Includes breaks, social / cultural events, excursion
    
US$75
US$150
*Please fill in below if you have any special needs, e.g. dietary requirements, wheelchair access, etc. Every attempt will be made to meet your needs.
Total amount payable in US$:
(in figures)
Select mode of transfer:
Banker's Cheque payable to AFRICOM2009
Western Union / Moneygram (visit the centre in your town)
Secure Online Payment
      (please click on Submit before proceeding to the online payment site)
Electronic transfer
*Please email us at conference@africom.museum for our bank details. All reference on transfers must include participant's name. Kindly send proof of bank transfer (by post, fax or email).
 
Have you submitted your Registration form? If so, you may proceed to
Secure Online Payment
Accomodation: A range of hotel options is available through a special online Booking System. Conference rates may only be obtained by booking online.

FOR FURTHER INFROMATION YOU MAY ALSO CONTACT
PASCALL TARUVINGA
OR FAX: +254 20 3748928

 

homepage homepage homepage sama