Conference Registration Form

Email Address

Full Name of Attendee (Title, First Name, Surname)

Affiliation/Organisation of Attendee

Gender of Attendee Gender of Attendee Male Female

Country

Mobile Number of Attendee

Please select membership/employment [where/if applicable (This will be verified by the organisation)] Please select membership/employment [where/if applicable (This will be verified by the organisation)] e/Merge Africa Leaders of Africa IIE

Would you be interested in attending this conference in 2023? Would you be interested in attending this conference in 2023? Yes No

Would you like to serve as a reviewer for future editions of this conference? Would you like to serve as a reviewer for future editions of this conference? Yes No

Where did you hear about this conference? Where did you hear about this conference? LinkedIn advert Group Mailing List Invitation email from organiser Invitation email from colleague/supervisor FB advert Other