University Advancement Workshop for University Leaders in Africa

REGISTRATION FORM

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* 1. Surname

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* 2. Other Names

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* 3. Gender

Female

Male

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* 4. Title

Miss

Mrs

Prof

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* 5. Position at your institution

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* 6. Name of Institution

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* 7. City

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* 8. Country

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

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* 10. Email Address

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* 11. I will pay my registration fees in this way

In advance by bank transfer

On site at the workshop

Other (please specify)

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* 12. Special dietary requirements

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* 13. Will you require transport to and from the airport?

Yes

Other (please specify)

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* 14. If you will require transport from the airport please indicate date and time of arrival and departure flights

Registration fees should be paid in full by transferring the registration fee ($500) to the AAU’s bank account no:

Account Name: ASSOCIATION OF AFRICAN UNIVERSITIES
Name of Bank: STANDARD CHARTERED BANK
HIGH STREET BRANCH
ACCRA-GHANA
Account Number: 87002-024488-01
Swift Code: SCBLGHAC
US Correspondent bank: SCB New York
Swift Code: SCBLUS33
ABA#: 026002561

Please send proof of payment to Mrs. Yvette Quashie. Email address: yaquashie@aau.org

THANK YOU