AfriNIC | Meeting | AfriNIC-7

Monday 21 May 2012

::: AfriNIC-7- Registration

If you have never registered online for any AfriNIC Meeting then please use
this registration form otherwise click on "Past Registrant".

Registration Form

Title:

* First Name:

Initial:

* Last Name:

* Job Title:

* Organisation:

* Industry:

* AfriNIC Member:

No Yes

* Email Address (Primary):

Email Address (Alternative):

* Phone Number 1:

Phone Number 2:

Fax Number:

* Street Address:

* City:

State / Province :

Postal Code / Zip:

* Country:

I plan to attend:

23 - 25 Sept		IPv6 Training
25 Sept Morning)		Internet Governance in Africa & Policy Makers

25 Sept (Evening)		Anti Spam BoF
25 Sept (Evening)		Newcomer Meeting

26 Sept		IPv6 Conference
27 Sept		AfriNIC Plenary 1
28 Sept		AfriNIC Plenary 2 (Morning)
IPv6 Training and Meetings cost: $ 75 Meetings Only: $ 50 2 participants per member will be entitled to the Training and Meetings free of charge Mode of Payment: Cash (On the spot) or Credit Card (details should be faxed)
28 Sept		African IXP

Send Invitation Letter?

No Yes

* Nationality:

* Passport #:

* Date Issued:

Day	Month	Year

* Place Issued:

Special food requirements:

Internet Connectivity Needs:

Is this your first AfriNIC Meeting?

No Yes

Publish My Name in the Participant List?

No Yes

Subscribe me to AfriNIC-7 mailing List

No Yes