Training Workshop on University-Industry Linkages
University of Ilorin, Ilorin, Nigeria

10th to 12th May, 2016

REGISTRATION FORM

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* 1. Surname

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* 2. Other Names

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* 3. Title

Mr

Miss

Mrs

Dr

Prof

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* 4. Position

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* 5. Name of Institution

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* 6. Address

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* 7. City

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* 8. Country

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* 9. Telephone Number (with City Code where applicable)

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* 10. Fax Number

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* 11. Email Address

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* 12. Registration Fee:

US $700 will be paid before 13th April, 2016

US $800 will be paid on arrival in Ilorin

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* 13. Will you need assistance with transport?

Yes

No

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* 14. Accommodation at Kwara Hotel

Standard Deluxe: US $125 -145

Junior Suite: US $160

Executive Suite: US $225

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* 15. Arrival Schedule

Arrival Date

Departure Date

Number of Nights

THANK YOU