REGISTRATION FORM

* 1. Title

* 2. Surname

* 3. Other Names

* 4. Position

* 5. Name of Institution

* 6. Address

* 7. City

* 8. Country

* 9. Telephone Number (with City Code where applicable)

* 10. Fax Number

* 11. Email Address

* 12. My choice three theme(s) are (tick):

* 13. Registration Fee:
* Registration waivers for female Vice Chancellors

* Half waivers for females in leadership positions in their universities (Deans and Directors of Institutions)

* 14. ACCORD HOTEL
http://accordhotel.rw/
Please select your choice room type

* 15. Accommodation

THANK YOU
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