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AMN Alluvial Mining Field School - Registration Form
Registration form for AMN Alluvial Mining Field School scheduled for June/July. Please kindly fill the following
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Middle Name
Your answer
Contact Number
*
Your answer
Country of Citizenship
*
Your answer
WhatsApp Number
*
Your answer
Email Address
*
Your answer
Education
*
Highest Education Attained
JSS/JHS
MSLC
WASSCE/SSCE
BACHELORS
MASTERS
DOCTORATE
None of the above
Other:
Organization (Work)
*
Where do you currently work?
Your answer
Are you a member of AMN
*
Applicable discounts exist for members of the Accra Mining Network who are in good standing
Your answer
Are you interested in an Event T-Shirt
*
If "Yes", state preferred size.
Your answer
What is your preferred luncheon for the field day
*
Choose
Banku
Fufu
Omutuo
Boiled Yam
Plain Rice
Jollof
Pasta
Fried Yam/Plantain
Fruits
What is your preferred Payment Method
*
Bank Transfer
MOMO
Cash
Credit Card - Mastercard, VISA, Discover
Required
Kindly state how you want your name written on the Certificate?
*
Your answer
What are your expectations for participating in the field school.
*
Your answer
Do you have any other comments, suggestions or recommendations?
*
Your answer
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