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PERSONAL INFORMATION
*indicates
required fields |
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| Title |
Preferred Name on Tag |
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| First Name |
Last Name* |
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| Email* |
Gender |
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Male
Female |
| Phone Number |
Mobile Phone |
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| City |
Postal Address |
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| Zip Code |
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| State |
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| Country |
Organization* |
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| Privacy (please check the box) |
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I
do not wish to have my name and organization
included in a public list of conference delegate |
| Date of Birth |
Passport Number |
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| Passport Expiration Date |
Special Needs |
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| Visa Assistance? |
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Yes
No |
| Your Citizenship |
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PAYMENT INFORMATION |
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| Registration
(students must send
proof of full time student status to
icacd@ccoghana.org. We accept either a valid
student card or a letter from the university). |
Accommodation |
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| Sightseeing & Cultural
Picnic |
Total Payment
(remember this total!
you will need it to pay by cheque, credit card or
Western Union. It is the sum of conference fees
and/or accommodation and cultural picnic). |
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€288 per
person |
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| Payment Mode |
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Bank Wire |
Cheque (make cheque
payable to International Conference on African
Culture and Development and mail to:
David Kwao-Sarbah, ICACD Secretariat, P. O. Box ANT
23045, Ash-Town, Kumasi). |
|
Western Union Money
Transfer (payment should be made payable
to ICACD 2008 .The code number and receiving
information about the transfer should be emailed to
icacd@ccoghana.org. |
| Arrival Date
(it will enable us to
make prior arrangement). |
Any Special Needs?
(please indicate any special requirement(s) whether
health or language which we should be informed). |
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| Departure Date
(it will enable us to
make prior arrangement). |
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| Contact Person
(in case of emergency) |
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Cancellation
Policy
Notification of any alterations or
cancellations must be sent by post, fax or email to
Theresa Onayemi (onayemi@ccoghana.org). Any delegate
canceling before Friday 13th April 2008 will
receive a refund of registration fees, less than
administrative fee of €50. No refunds will be made
after Friday 13th April 2008. If you are unable to
attend, you may nominate someone else to attend in
your place at no additional cost. |
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