Registration

Support Form (#2)

First Name

Middle Name

Last Name

Email

Phone

Gender

Affiliation

Organisation

Nationality

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country of Residence

Registration Fees

SENIOR	1000 MAD
JUNIOR	500 MAD

You will receive an email about the payment procedure once you have completed your registration.

Gala dinner

INCLUDED WITH ROUND-TRIP TRANSPORTATION AND ENTERTAINMENT.	550 MAD