Conference Registration Form

Enviado por editor el Jue, 24/04/2008 - 03:31.

Prefix:

Mr. Ms. Dr.

First Name: *: *

Last Name: *

Name for Badge:

Name you would like to have on your Badge

Movement/Organization:: *

The name of your Movement/Organization:

Phone Number: *

Please include country and area code. Format (123)-(123)-12345678

E-mail Address: *

Address: *

City: *

State/Province: *

Postal Code: *

Country: *

Please choose the individual registration type if you will be coming alone. If you are coming as a family of 2 or more please choose the family registration type. We will use this information for lodging arrangements

Please select registration type: *

Individual (1)

Family (2-4)

Will you need a hotel reservation?: *

Yes

No

Special Dietary Needs:

Yes

No

If yes indicate any particual food you want below

Dietary Needs:

Please indicate your tour interest:

Yes

No

Please indicate if you would like to go for a tour

Conference fees €100/person

Registration fees (all fees listed in Euro Funds) includes accommodation (only for Pax Romana delegates), lunch, Break, and proceedings

The Secretariat
Tel: +254 (0) 721 378 808

Global Governance, Global Justice

Conference Registration Form

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