I nternational Conference on Law Reform
〰️ 4th-5th April 2019 〰️
Livingstone, Zambia
Successful Law Reform: Practical Issues Today
REGISTRATION FORM
Kindly complete the form and e-mail it by 25th March 2019 to: [email protected]
Title/Designation (as you would prefer it to appear on your name tag):
Name (as you would prefer it to appear on your name tag):
Email address:
Organisation represented:
Postal Address:
Zip/Post Code:
Telephone No.:
Cell Phone/Mobile Phone No.:
What days will you attend?
4
5
I will attend the Conference dinner on 4th April (US$25.00 per person):
Y
N
I will bring a guest to the conference dinner. (Delegates are permitted to bring one guest at US$25.00):
Special requirements (for example, dietary or mobility/access requirements):
Conference Fees (excluding additional conference dinner costs):
By 28th February 2019 - US$200 **Payment must be received before March 1st to qualify.**
After 28th February 2019 - US$225
Day Rate - US$125
There is a standard cancellation fee of US$25, or US$100 after 25th March.
A participant may be replaced by another person without charge.
Payment
Payment can be made by Bank Transfer using the details below.
**Please include your name as the online payment reference**
Account number - 59936263
Sort code - 77-49-26
I agree that I shall inform the organiser immediately if I am prevented from attending the CALRAs Conference or Dinner after confirming my attendance.
I agree that my contact details can be passed to delegates and others unless I indicate otherwise here.
Signature:
Date:
14 8BXXXE INTERNATIONAL TELECOMMUNICATION UNION RADIOCOMMUNICATION STUDY
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