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Mile 19 Community

3rd Leadership Retreat Follow-up Meeting

Tuesday July 29 to Friday August 1, 2008

Online Registration Form

Complete relevant form sections below, print a copy for your records, and press submit to send your registration request.

Personal/Company Information

Name:

Title:

Organisation/Company:

Address:

Phone:           Fax:

E-mail:

             Please do not include my email address in the Meeting folder participant list

 

Accommodation Reservation Request

Reserve accommodation for me:

                                          Hotel

                                          Stay with family

Special Needs Information

I have the following special needs:

Dietary restrictions/food allergies. Details

Mobility. Details

Hearing. Details

Sight. Details

Others. Details

Special Events       

I will participate in the following Special Events:

Religious/prayer Meetings                         Seeking Justice in the Community

Home Economics Demonstrations               Other Tours

Dance Workshops                                     Sports             

Organization and Project Cycle

Exhibit/Poster Display/Booth Space Request

Please reserve display/booth space for me/my group/organization/business

Please indicate your issue/product/service category

Water/Hygiene/Sanitation

Health/Medicines/Food/Nutrition

Agriculture/Agro-technologies/chemicals/extension

Household Equipment/cooking/bathing/lighting/eating/...

Education/Schools/Adult literacy

Media & Information Communication Technologies (ICTs)

Others. Please specify            

We recommend that you print this screen for your records before submitting this form.


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 EITD Research Exhibition, Workshop, Seminar and Conference Services

EITD Research (Research for Enterprise, Industries, Technology and Development)

P.O. Box 168, Kumba, South West Province, Cameroon.

Tel/fax: (237) 3335-4623 Email: info@eitdr.org Website: www.eitdr.org
For problems or questions regarding this Web site contact mile19@eitdr.org.

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