Registration Form - African Heads of Space Agencies Forum CountryNot listedAlgeriaAngolaBotswanaCote d'IvoireDRCEthiopiaEswatiniGabonGhanaEgyptKenyaMalawiNamibiaNigeriaSenegalSouth AfricaSouth SudanUgandaZambiaZimbabweVisa Assistance(Required) Yes (assistance needed) No (no assistance needed) Registration InformationPlease provide the basic registration information, including selecting the number of delegates to enter their information.Registration Officer(Required) Prefix Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. First Last Job Title(Required) Organisation(Required) Email(Required) Enter Email Confirm Email Delegates(Required) Delegate #1 Delegate #2 Delegate #3 Select AllDelegate #1Name(Required) Prefix Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. First Last Job Title(Required) Email(Required) Dietary(Required) Special Dietary Needs Special Dietary Needs(Required)Delegate #2Name(Required) Prefix Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. First Last Job Title(Required) Email(Required) Dietary(Required) Special Dietary Needs Special Dietary Needs(Required)Delegate #3Name(Required) Prefix Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. First Last Job Title(Required) Email(Required) Dietary(Required) Special Dietary Needs Special Dietary Needs(Required)SubmitCAPTCHA
