ICHE ANNUAL CONFERENCE 2018
REGISTRATION DEADLINE IS MARCH 31, 2018
CONFERENCE REGISTRATION FORM
(The registration deadline is March 31, after which the hotel accommodation fees may change)
Your Title: *
(Ms, Mrs, Mr, Dr, Rev, Bishop, etc.)
Your answer
Your Name: *
Your answer
Your email address: *
Your answer
Name of the institution you represent: *
Your answer
Your designation: *
Your answer
Institution postal address: *
Your answer
Country *
Your answer
Telephone: *
Your answer
Gender *
TOTAL FEE PER PERSON (includes Registration & Conference and Hotel Room Fees) *
See poster above for fee details. ALL HOTEL ROOM FEES TO BE PAID DIRECTLY TO THE HOTEL. There is a separate "credit card form" for hotel payments. Registration & Conference Fees can be paid to ICHE via wire transfer (www.ichenetwork.org) or via PayPal (contact nroberts@ichenetwork.org for an invoice).
Required
Roommate (for DOUBLE OCCUPANCY only): *
Roommate's Name (as per her/his registration) and Organisation:
Your answer
Arrival Date:
MM
/
DD
/
YYYY
Flight Arrival Time:
Time
:
Flight Number (Arrival):
Your answer
Departure Date:
MM
/
DD
/
YYYY
Flight Departure Time:
Time
:
Flight Number (Departure):
Your answer
Do you require an official invitation for obtaining a GHANA visa? *
Required
If you have any questions, if you have dietary restrictions, or if you would like to share any additional information/details, please do so here:
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