DELEGATES REGISTRATION FORM Notice: Undefined offset: 1 in /home/cilt/event.ciltgh.org/e/wp-content/plugins/arforms/core/controllers/arrecordcontroller.php on line 6816 Notice: Undefined offset: 1 in /home/cilt/event.ciltgh.org/e/wp-content/plugins/arforms/core/controllers/arrecordcontroller.php on line 6816 Prevent Duplicate EntryForm is successfully submitted. Thank you!Online Registration FormKindly complete form below to register for the CILT Forum 2021 in Accra, Ghana. Please use CAPITAL LettersPersonal / Contact Details TitlePlease selectProf.Dr.Mr.Mrs.Ms.Other.Surname Name*First Name*Other NamesGenderMaleFemaleOtherDate of BirthEmailYour current Job Title*Phone Number*Passport NumberWhatsApp Number* Organization Information Organization Name*WebsiteAddress*Address Line 2Country*Please selectAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCroatia (Hrvatska)CubaCyprusCzech RepublicCongo (DRC)DenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Islas Malvinas)Faroe IslandsFiji IslandsFinlandFranceFrench GuianaFrench PolynesiaFrench Southern and Antarctic LandsGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong Kong SARHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKoreaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao SARMacedonia, Former Yugoslav Republic ofMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabweCity*Are you a CILT Member?*YesNoWhat is your current grade of membership?*Please select oneStudent MemberAssociate/Affiliate MemberMember (MILT)Retired MemberChartered Member (CMILT)Retired Chartered MemberRetired Fellow (FCILT)Retired FellowLife MemberHonorary MemberNon MemberCILT Membership Number (If N/A please type ‘0’)*Flight DetailsArrival Date:Time:Flight No.:Departure Date:Time:Flight No.:Dietary/Accessibility RequirementsI have read the document and give my authority to be photographed, filmed and/or recorded?*YesNo Participation Fee/Packages Participation Fee & Package (Accommodation is not included in any of these packages) Delegates have an added advantage of Early Bird Discount (15%) which ends on February 17, 2020Are you a local or international delegate?*Local delegateInternational delegateLocal Delegate PackagePlease select the package that applies to youCILT Member – GHC 700.00WiLAT GHC – GHC 600.00 YP GHC – GHC 600.00CILT Student – GHC 500.00Others GHC – 850.00Corporate Member – GHC 1,000.00Non-Corporate Member – GHC 1,200.00Participation Fee & Package for local delegatesInternational Delegate PackagePlease select the package that applies to youCILT Member – $330.00WiLAT GHC – $280.00YP GHC – $250.00Others GHC – $350.00Corporate Member – $500.00Non-Corporate Member – $600.00Participation Fee & Package for International delegates Optional Package Guided Tour with Lunch on 5th March*Boat Cruise to Dodi World – $50Akosombo Hydro-Electric Station – $50No, not interested SubmitPowered by ARForms (Unlicensed)Online Registration FormPrint
