2nd International Leadership Conference for Women in Higher Education
March 6-8, 2019| Nairobi, Kenya
Theme: Promoting Women in Science to Address the 21st Century Challenges

Delegate Information

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1. Title/Titre (Required.)

Miss/Mlle

Mrs/Mdme

Prof

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2. Surname/Nom (Required.)

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3. Other Names/Prénoms (Required.)

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4. Gender/Sexe (Required.)

Male/Masculin

Female/Féminin

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5. Position/Poste (Required.)

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6. Name of Institution/Non de l’Institution (Required.)

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7. Address/Adresse

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8. City/Ville (Required.)

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9. Country/Pays (Required.)

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10. Telephone Number (with City Code where applicable)/No. de tel. (avec le préfixe s’il y lieu) (Required.)

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11. Email Address/Adresse email (Required.)

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12. Select Participation type/Sélectionner le type de participation (Required.)

Registration fee: USD 200 (for women participants)

Registration fee: USD 50 (for female students)

Registration fee: USD 300 (for other participants)

Registration fees should be paid in full by transferring the registration fee to the bank account no / Les frais d'inscription doivent être payés intégralement par transfert au compte bancaire:. Those who wish to pay onsite should indicate that in writing to fnkrumah@aau.org

ACCOUNT NAME: Association of African Universities

BANK NAME: Standard Chartered Bank

Branch: High Street Accra-Ghana

ACCOUNT NUMBER: 8700202448801

SWIFT CODE: SCBLGHAC

CORRESPONDENT BANK: Standard Chartered Bank New York

SWIFT CODE: SCBLUS33

ABA No. 026002561

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13. How did you get to know of this conference? (Select more than one avenue if it applies in your case) / Comment avez-vous eu connaissance de ces ateliers? (Sélectionnez plus d'une voie, le cas échéant) (Required.)

Newspaper Advertisement / Publicité sur les journaux

Direct Email / Courrier électronique direct

AAU Newsletter / Bulletin de l'AUA

Phone Call / Appel téléphonique

AAU Websites: aau.org or blog.aau.org / Sites Web de l'AUA: aau.org ou blog.aau.org

Social Media / Médias sociaux

Bulk SMS / SMS groupés

Word of Mouth / Bouche à oreille

Other (please specify) / Autre (veuillez préciser)

THANK YOU | MERCI

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* 1. Title/Titre (Required.)

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* 2. Surname/Nom (Required.)

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* 3. Other Names/Prénoms (Required.)

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* 4. Gender/Sexe (Required.)

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* 5. Position/Poste (Required.)

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* 6. Name of Institution/Non de l’Institution (Required.)

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* 7. Address/Adresse

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* 8. City/Ville (Required.)

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* 9. Country/Pays (Required.)

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* 10. Telephone Number (with City Code where applicable)/No. de tel. (avec le préfixe s’il y lieu) (Required.)

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* 11. Email Address/Adresse email (Required.)

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* 12. Select Participation type/Sélectionner le type de participation (Required.)

Question Title

* 13. How did you get to know of this conference? (Select more than one avenue if it applies in your case) / Comment avez-vous eu connaissance de ces ateliers? (Sélectionnez plus d'une voie, le cas échéant) (Required.)

1. Title/Titre (Required.)

2. Surname/Nom (Required.)

3. Other Names/Prénoms (Required.)

4. Gender/Sexe (Required.)

5. Position/Poste (Required.)

6. Name of Institution/Non de l’Institution (Required.)

7. Address/Adresse

8. City/Ville (Required.)

9. Country/Pays (Required.)

10. Telephone Number (with City Code where applicable)/No. de tel. (avec le préfixe s’il y lieu) (Required.)

11. Email Address/Adresse email (Required.)

12. Select Participation type/Sélectionner le type de participation (Required.)

13. How did you get to know of this conference? (Select more than one avenue if it applies in your case) / Comment avez-vous eu connaissance de ces ateliers? (Sélectionnez plus d'une voie, le cas échéant) (Required.)