Thank you for registering to attend the ERLN Conference-Economies of Regions: Economic Development at the Sub-National Level

We want to make the process as easy as possible. You will need to complete a separate registration form for each individual attending.

There is no fee for attending the conference but due to limited space we are asking delegates to complete their motivation for attending

If you have any questions about registration, please contact Rozale Sewduth at Rozale@tips.org.za or +27 12 433 9340

DELEGATES DETAILS:
TITLE:	Choose an item.
FIRST NAME:	Click here to enter text.
SURNAME:	Click here to enter text.
NATIONALITY:	Click here to enter text.	GENDER
ORGANISATION DETAILS
NAME OF ORGANISATION:	Click here to enter text.
YOUR POSITION:	Click here to enter text.
ADDRESS:	Click here to enter text.
POSTAL CODE:	Click here to enter text.	CITY:	Click here to enter text.
TELEPHONE:	Click here to enter text.	FAX:	Click here to enter text.
MOBILE:	Click here to enter text.	EMAIL:	Click here to enter text.
MOTIVATION FOR ATTENDING (please keep to 50-100 words)
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PRE-REGISTRATION IS ESSENTIAL FOR SEATING AND CATERING PURPOSES
I will be attending on the following conference days:
☐	Thursday, 15 October 2015 - Conference
☐	Friday , 16 October 2015 - Conference
SPECIAL REQUIREMENTS/OTHER
List any special requirements, including dietary requirements:
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