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AFSTA CONGRESS 2007 REGISTRATION FORM

 

DELEGATE
Title
Surname :
First Name 
Nationality
Position
Employer
City
Country
Tel 
Fax
E-mail 
Preferred name on ID badge
ACCOMPANYING PERSON
Title
Surname :
First Name 
Nationality
Position
Employer
City
Country
Tel 
Fax
E-mail 
Preferred name on ID badge
FLIGHT ARRIVAL/ DEPARTURE DETAILS
Date of arrival Flight No  Time
Date of departure Flight No Time
A non-refundable deposit of US $ 150 is required for hotel reservation
ACCOMMODATION (tick the hotel of your choice)
Zambezi Sun Hotel (Congress Hotel)  

Fairmount Hotel

Date of arrival Date of departure  Number of nights
 

EXHIBITION SPACE

Minimum unit of 3m x 2m = 6 m² at the cost of US$ 370

Cick here to view the map
No of units preferred
MEALS
LUNCHES (Optional) Please tick the days you wish to have lunch (US$ 26 per meal)

7 March

8 March 9 March    
 
Congress registration fees
US$ 
Accommodation (deposit )                               
US$ 
Exhibition space           
US$ 
Lunch      
US$ 
TOTAL       
US$ 

              

 

Instruction for payment

The registration fees, accommodation deposit, any exhibition space fees are payable by bank transfer, banker’s cheque (Personal Cheques are not accepted) or by credit cards in US$ Currency only. Please note that you are required to pay all the bank charges while transferring the money to AFSTA Secretariat. Any bank charges taken by the bank will be payable to AFSTA Secretariat upon registration at the venue.

Payment can be made by bank transfer to the following bank: 

•  Bank: Barclays Bank of Kenya, Moi Avenue Branch, Nairobi, Kenya

•  Account Name : AFSTA Events

•  Account number: 7055480

•  Swift code: BARCKENX

By credit cards

The following credit cards are accepted: VISA, AMERICAN EXPRESS AND MASTERCARD

Amount to be charged on your credit card in US$: ………………………………………………

Credit Card Number: _ _ _ _ / _ _ _ _ / _ _ _ _ /_ _ _ _

Expiry Date: _ _ / _ _ _ _

Credit Card Holder’s:

Name: ………………………………………………

Signature for authorization: ……………………………………..

PLEASE ALSO SEND A COPY OF BOTH SIDES OF CREDIT CARD

AND A COPY OF YOUR PASSPORT WITH THIS SIGNED FORM

(By Fax: +254 20 2727861 or by E-mail in electronic version: afsta@afsta.org )

  • By Banker’s cheque
  • To be sent by registered mail to AFSTA Secretariat at the following address:

Ms Susan Miyengi, AFSTA Secretariat, P.O. Box 2428 – KNH, Nairobi, Kenya

 

 
 
 
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