african conference on edible insects registration form · 2019-06-03 · african conference on...
Post on 23-May-2020
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African Conference on Edible Insects 14-16 August 2019
African Conference on Edible Insects Registration Form
We thank you for your interest in participating at our conference. Fill in our Conference Registration Form below to receive your badge number and the schedule of the entire event. Return the form and attach proof of payment to: agrifose@cut.ac.zw
Name of Attendee……………………………………………………………………………..
Organization/Company……………………………………………………………………….
Address……………………………………………………………………………………………………………………………………………………………………………………………..…………………………………………………………………………………………………...……………………………………………………………………………………......................Email……………………………………………………………………………………………
Phone number………………………………………………………………………………….
Type of Registration (Please tick the appropriate)
Student
Regular
Exhibitor
Do you require accommodation?
Yes
No
Payment/ Banking DetailsBank Name: First Banking Corporation
Account name: Chinhoyi University of TechnologyAccount number: 1140042840350
Bank Address: 5309 Magamba Way, ChinhoyiTelephone number: +263 67 24086/ +263 67 25308
Branch code: 8511Swift Code: FBCPZWHA
(attach current student ID)
African Conference on Edible Insects 2019
Do you wish to attend the conference dinner on 14 August 2019?
Yes
No
Do you have any dietary special requirements?
Yes
No
If yes, Please specify
………………………………………………………………………………………………………................
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