THE 2ND AFRICAN SCIENCE COMMUNICATION CONFERENCE
ONLINE CONFERENCE REGISTRATION APPLICATION 		 
     
 
 
     
 

The 2nd ASCC is set for February 18-21 2009 in Gauteng, South Africa. To attend, please complete the conference registration application form below, on or before October 16 2009.

For additional information, contact the conference registrar by telephone: +27 12 392 9300 or email: conference@saasta.ac.za / 2ndascc@saasta.ac.za

PLEASE NOTE: Since nametags will be produced from the submitted/supplied information, please submit a seperate form for each registrant.

  
     
 
 
     
  PARTICIPANT INFORMATION  
   
 
Name: *
   
Title: *
   
Organisation: *
 
     
 
Address: *
 
   
City: *
   
Postal Code : *
 
     
 
Country: *
   
Telephone: *
   
Fax:
   
Email: *
 
     
 
 
     
  SPECIAL NEEDS  
     
  Please tick all that apply.  
     
 
Kosher
 
 
French translation
 
 
Wheelchair access
 
 
Sign interpretation
 
 
Vegetarian
 
 
Halaal
 
 
Other
 
     
  If other, please specify:  
     
   
     
 
 
     
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