Registration form

CC-POP GHANA 2018: Online Registration Form

23 – 25 July 2018

University of Ghana
Accra, Ghana
Phone: +233 (0) 547 836 283

 E-Mail info@ccpopghana.org

Title

Last Name

Professional Designations

Institution / Company

Mailing Address

City/ town

Country:

Phone:

Type of Profession
IndustrialistResearcherPractitionerTeaching / AcademiaOther

Meeting Information
YesNo

Moderation - Would You Like to Moderate or Chair a Session?
YesNo

Area of Expertise (Please tick all that apply)
PolicyIndustrySocial ScienceBiophysical Science InterdisciplinaryOther (specify)

Membership of Professional Bodies
Are You a Member of a Professional Society? If Yes Which?
YesNo
Please ignore if you chose NO

Registration Fees......................Early (April 15 – June 14, 2018).....Regular (June 15, – July 14 2018)
Non-African Passport Holders .....(Early / US$150).....(Regular / US$200)African Passport Holders (non-students) .....(Early / US$100).....(Regular / US$200)Non-presenting students (ID required) .....(Early / US$80).....(Regular / US$100)Presenting students less than 30 years (ID required).....(Early / FREE).....(Regular / FREE)Presenting students – 30 years & above (ID required).....(Early / US$50).....(Regular / US$80)

Carbon Offset Fee(Optional) = GH¢30 (Your travel to this meeting has resulted in the emission of Greenhouse Gases from Transport and other Consumptive Activities such as Food and use of Electricity so we want you to be Part of a project that reduces Emissions)Donations to Enable Less Privileged Participants from the South to Attend. You will be contacted

Payment Method
Kindly scan and upload proof of payment
Bank TransferElectronic/ Online (Visa Card Only)Wire Transfer (Western Union / GT Bank Money Transfer / MPESSA / TIGO Cash)Other

Upload Proof of Payment Here if Applicable

Cancellation
No refunds on cancellations from July 15, 2018