Workshop on University-Industry Linkages Obafemi Awolowo University, Nigeria 25th – 28th April, 2017

REGISTRATION FORM

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* 1. Surname

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* 2. Other Names

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* 3. Title

Miss

Mrs

Prof

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* 4. Position

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* 5. Name of Institution

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* 6. Address

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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. Fax Number

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* 11. Email Address

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* 12. Registration Fee:

US $600 will be paid before 10th April, 2017

US $700 will be paid on arrival in Ile Ife

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* 13. Will you need assistance with transport?

Yes

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* 14. Accommodation at OAU Conference Centre and Chris Court

Conference Centre - Mini Suite: US $55/night

Conference Centre - Chalet: US $45/night

Conference Centre - Executive Double: US $40/night

Conference Centre - Luxury Double: US $35/night

Chris Court - Executive Suite: US $120/night

Chris Court - Superior: US $110/night

Chris Court - Deluxe: US $85/night

Chris Court - Standard: US $75/night

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* 15. Arrival Schedule

Arrival Date

Departure Date

Number of Nights

THANK YOU