Registration

Registration deadline 21st May 2018

* required fields

Email address*
Email address (confirm)*
Name*
Firstname*
Home institution*
Department/Office*
Street and number*
Postal/Area Code*
City*
Country*
Phone*
Welcome Reception – June 6th, 2018*
Lunch on June 7th, 2018*
Do you need a room for networking on 7th June 2018 (optional)?*
Africarium on June 7th, 2018 (optional – 10 EUR)*
Dinner on June 7th, 2018*
Your favourite song you would like to hear during the Gala Dinner
Lunch on June 8th, 2018*
Eating Preferences*
Allergies or special dietary request
Guided City Tour on June 8th, 2018 (optional – 10 EUR)*
Membership details*
Additional remarks
Upload your photo (JPG format only !)
(Your photo will be published only on the list of participants)