SUSTAINABLE WATER CONFERENCE REGISTRATION FORM
REGISTRATION FORM
Full Names :
Title:
Institution/Company:
Position:
Address:
E-mail:
Telephone:
Fax:
Nationality:
I intend to apply for a visa through:
The Embassy of Kenya:
Assistance from the organizers
Other (please specify
Have you secured sponsorship for the conference?
(If 'NO' What are your plans for sponsorship?)
Yes
No
Plenary lecture:
I plan to present:
Short lecture:
Young scientist presentation:
Poster:
Do you need the Organizing Committee to book you in a hotel?
Details of any special requirement/disability/medical condition that the Organizing Committee should know?
Yes
No
PAN AFRICA CHEMISTRY NETWORK
