Donor Grants Funding for Projects Workshop for African Universities and Colleges - 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, please 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 Organization/Institution/Association
Your answer
Name of Nominated Staff
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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