:. PM AFRICA CONFERENCE.:

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APMC'2012 CONFERENCE REGISTRATION FORMS

Download Conference Registration Form

Fill the Online Form Below & Submit:
Note: The asterisk* indicates compulsory fields.

ONLINE REGISTRATION FORM

Date:

Your Title (Prof/Dr/Mr/Mrs/Ms.) *

Name (Last, First) *

Marital Status *

ID./ Passport No *

Organization/Company:

Position:

Nationality *

Current Country of Residence *

City:

State or Province:

Postal Code(Zip):

Street Address:

E-Mail:

Tel/Phone Number *

Fax Number:

Address *

Emergency Contact (Name & Phone):

Will you need to park a car at Kenyatta International Conference Centre during the Conference?: * Yes No

Are you an African Community Citizen? * Yes No

Do you require a visa?* Yes No

Please indicate your participation category (check all that apply):

Consultancy

Academic

NGO

Media

Corporate

Policy/Decision Maker

Provisional Association

Promoter

Supplier

Development Agency

Government

Other (Specify)

How did you hear about the Africa Project Management Conference (APMC 2012)?*

E-mail

Brochure

Word of mouth

Website (Specify)

Other Source (Specify)

Conference Registration Fee *

Early Bird Registration (payment received on or before 2nd March 2012)

US$150

Late Registration (payment received after 2nd March 2012)

US$160

PAYMENT INFORMATION

Payment can be made to the following Account

BANK:	Cooperative Bank of Kenya
BRANCH:	Stima Plaza Branch, Nairobi
ACCOUNT No:	A/c No.0113656408200,
ACCOUNT NAME:	Project Management Group Ltd.

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Download Conference Registration Form