The document is a registration form for a program on "Decision Support Tools for Agricultural Production, Fertilizer Recommendations and Climatic Variability" being held in Arusha, Tanzania from July 2-13, 2012. The registration fee is $1,300 if received by June 2, 2012 and $1,500 if received after including a $200 late fee. The form requests information such as name, position, organization, contact details, arrival/departure dates and signatures. It also provides details on deposit requirements, cancellation fees and refund policies.
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Dst registration form
1. Program Registration Form
Decision Support Tools for Agricultural Production, Fertilizer
Recommendations and Climatic Variability
Arusha, Tanzania – July 2-13, 2012
Program Registration Fee:
US $1,300 if received by June 2, 2012 (without penalty)
US $1,500 if received after June 2, 2012 (includes US $200 late fee)
Please Print or Type your legal name as you would like it to appear on ALL printed material.
(Dr., Mr., Mrs., Ms., Miss) Given Name (First Name) Surname (Last Name)
Position
Organization or Employer
Work Mailing Address
City State Country
Work Tel. No.: Fax No.: Home Tel No.:
E-Mail:
Organization/Company Funding Your Participation
Arrival Date and Time: Flight Number: Departure Date and Time: Flight Number:
Signature of Applicant Date
Signature of Employer/Funding Organization Date
Note: A non-refundable deposit of US $200 is required with each registration. The deposit will be credited towards the program fee which is due
four (4) weeks before the program is scheduled. Thereafter, a Late Fee will apply. The program fee, less the deposit, will be refunded for
cancellations made two (2) weeks before the commencement of the program. Ninety percent of the paid fee will be returned and 10 percent, in
addition to the deposit, will be charged to cover administrative costs for cancellations made between two (2) weeks and one (1) week before the
commencement of the program. Cancellations made less than one (1) week before the commencement of the program will receive no refund.
2. IFDC reserves the right to cancel any program or change the dates and/or venue of any program without liability for compensation.