AHRO - International HIV/AIDS Conference

Related Links
	Conference Program
	Program Line up
	Call for Abstract
	Sponsors & Exhibitors
	Tour

Registration Form

Please complete the following form (this must be completed once for each delegate) then click “Submit Form Details” to process the registration.

Alternatively you may print the form, complete in BLOCK CAPITALS (once for each delegate, photocopies are valid) and return with full payment to:

AHRO 2008 Secretariat,
Africa Health Research Organization
32 Ash Grove Hayes UB3 1JR

All fields are compulsory.

First Name
Family Name
Designation/Professional Status
Institute/Hospital/Company
Address
City
Postal/Zip Code
Country
Email
Profession
Phone Number (Including Country and area code):
Office
Res
Mobile
Fax

Delegate (in £) 30^th July, 2008		Person	Early (till) 30^th July, 2008	Late (after) 30^th July, 2008
	Full conference		270	290
	Full conference (Developing countries)		140	160
	Accompanying person-Above 18 (All countries)		100	100
	Accompanying person- U18 (All countries)		50	50
		Total

Methods of Payment

By cheque ( Sterling only)

No:

Dated:

By Direct Bank Transfer

By Company Payment against our invoice (In Pounds only)

By Credit Card (3.5% surcharge)

	I agree by the terms and conditions as laid out for this event

Website last modified on12 Feb 2008