REGISTRATION FORM

Surname

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* 1. Surname

Other Names

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* 2. Other Names

Title

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* 3. Title

Position

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* 4. Position

Name of Institution

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* 5. Name of Institution

Address

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* 6. Address

City

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* 7. City

Country

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* 8. Country

Telephone Number (with City Code where applicable)

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

Fax Number

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* 10. Fax Number

Email Address

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* 11. Email Address

Registration Fee:

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* 12. Registration Fee:

Will you need assistance with transport?

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* 13. Will you need assistance with transport?

Accommodation at Voila Bagatelle Hotel, Mauritius

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* 14. Accommodation at Voila Bagatelle Hotel, Mauritius

Arrival Schedule

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* 15. Arrival Schedule

THANK YOU

T