Venue & Accommodation Registration Form

 
Event: EAGC meetingDate of Booking:Tuesday 7 February 2012
 
Personal Particulars
Last Name:First Name:
Company:
Passport Number:Date of Birth:  
Email Address:Nationality:
Address:Phone:
Fax:
Mobile:
No. of Guests:Origin of Guest:
Single room B & B 195.00 USD taxes included
ACCOMMODATION
Arrival Date:Departure Date:
Number of Nights:Room Type:
Room: Single       DoubleSmoking: Yes       No
TRANSFER SERVICE
Airport pickup at $20 person per trip
Flight Details:
Expected time of Arrival:Expected time of Departure:
Service Required: Yes       No 
Credit Card Authorization
Credit Card Number:Expiry Date:
Name of the card holder:Signature of the card holder:
As a security measure, please type 810772 here: 

4th African Grain Trade Summit 2011 ©2011 East African Grain Council. all rights reserved