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AFSTA CONGRESS 2010 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

DIETARY REQUIREMENTS (Please state your dietary requirements)




ACCOMMODATION

Please note that you will have to pay directly to the hotel in Bamako, Mali. Also book in advance to secure accommodation as space is limited and there is a high demand during this peak season. You can follow the links provided to download the form and email or fax it directly to the hotel of your choice.

We have notified the hotels that you are our delegate and will therefore enjoy the special acommodation rates.

The following three hotels are available for accommodation

1. Azalaï Hôtel Salam (Congress Hotel)   
2. Azalaï Grand Hôtel  
3. Azalaï Hôtel Nord Sud  
   

 

 
EXHIBITION SPACE

Unit of 3m x 2m at the cost of US$800

Indicate the number of booth as shown in the exhibition map in the dropdown below.

Click here to view the map of exhibition booths
 
Select if AFSTA member or not
Congress registration fees
US$
Exhibition booth           
 
US$
TOTAL       
US$

              

Instructions for payment

The registration fees and any exhibition space fees are payable by bank transfer, banker’s cheque (Personal Cheques are not accepted) or by credit card in US Dollars only. Please note that you are required to pay all the bank charges while transferring the money to AFSTA Secretariat.

Payment can be made by Bank Transfer to the following bank: 

  • Bank: Barclays Bank of Kenya, Moi Avenue Branch
  • Account Name: AFSTA events
  • Account number: 7055480
  • Swift code: BARCKENX

The following credit cards are accepted: Visa, MasterCard, and American Express

By Credit Card

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 Bankers 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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P. O. Box 2428 - 00202, Nairobi, Kenya | Tel; +254 20 2727860