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INITIAL REGISTRATION FORM
 
Title:
First Name:
Surname
     
Organization
or Local Authority Name:
Deptartment:
Position:
   
E-mail address:
Telephone number:
Fax number:
Cellphone or Mobile:
   
Country:
 
SECTOR (Please tick the following):
   
 
International Delegate (excl. Africa):
 
 
City from Africa:
     
NGOs / CBO's and Academics:      
National, Provincial government and National bodies:      
Local Authority:      
Donor agencies:      
Business:
 
 
Media:
 
 
Other (please specify):
     
Please indicate if you will be attending the African Energy Cities Network Discussion:
I am interested:
I will Not be attending:
 
     
 
 
 
 
The registration form is automatically submitted to:
 
Geraldo Rodrigues
African Equations
Tel: 021-461 5735
fax: 021-461 5775
geraldo@africanequations.co.za
 
COST
 
The conference fee is R 900 (works out to R200 a day excluding climate levy).
This fee is subsidized and includes a climate levy.
Registration cut-off date: 30 September 2003
A non-refundable additional late registration fee of R300.00 will be charged after the cut-off date of 15 October 2003.
Substitutions will be accepted at an additional fee of R 300.00 per person.