Donor Grants Funding Workshop - Sep. 27 - 29, 2017 at Tulip Inn Hotel, Accra-Ghana
Nomination Form.
Please complete the form below and submit. (In case you are a team, each individual is to fill one form to help make the necessary arrangements). If there are any challenges, don't hesitate to get in touch through bsa@accamail.com or +233 (0)202237853 / +233 (0)55 369 5857 / +233 (0)205220810.
PARTICIPATION FEE:
1. Ghanaians Gh¢1,699.00 (Without Accommodation)

2. Non-Ghanaians $850.00 (With Accommodation and Airport Pickup)

Name of Nominated Staff *
Your answer
Name of Organization/Institution/Association *
Your answer
Position of Staff *
Your answer
Contact Phone Number(s) *
Your answer
Email Address *
Your answer
Country of Origin *
If Ghana, do you Require Accommodation Arrangement for you or your team
Type of Organization/Institution/Association *
Your answer
Date of Registration of Organization/Institution and Registration Number *
Your answer
Staff Strength of Organization/Institution/Association *
(Total number of staff working with the institution/organization/association)
Your answer
Location of Organization/Institution/Association *
Your answer
Contact Phone Number(s) of Head of Organization/Institution/Association *
Your answer
Area(s) of Interest(s) of Organization/Institution/Association *
Your answer
Do you have a project idea(s) already *
If Yes, Title of Proposed Project for which you are seeking funding
Your answer
Estimated Amount of Funding you are Seeking in US$ *
Number of Staff Nominated to Participate *
(Number of persons nominated by the institution/organization/association to participate in the workshop)
Your answer
Total Participation Fees (US$ / Gh¢) *
(Note: Ghanaians Gh¢1,699.00 without accommodation / Non-Ghanaians $850.00 with accommodation and airport pick up)
Your answer
Payment Method
(Note: All payments are to be made before 20th September 2017 to avoid any inconvenience)
Assistance with Payment of Fees?
BANK PAYMENT DETAILS
Account Name: BS AFRICA LIMITED

Bank Name: ECOBANK GHANA

Account Number: 038 001 4428 33 5801

Branch: WESTLAND, ACCRA - GHANA

CONTACT DETAILS
Email: bsa@accamail.com

Mobile: +233 (0)202237853 / +233 (0)553695857 / +233 (0)205220810

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