6th International African Palliative Care Conference

Items marked with an asterisk (*) must be filled in.

Note: This registration is for Rwanda Nationals only. If you are not a citizen please click here for registration

National ID*

First name *

Surname *

Title (Mr, Mrs, Dr, etc) *

Gender *

Male Female

Identity / Passport number

Institute/Organisation *

Telephone number *

Please also provide a cellphone number so that we are able to reach you while you are at the conference.

Cellphone number

e-mail address *

Contact incase of an emergency *

Is this you first time to attend an APCA conference?

Yes No

If yes, then how did you hear about it?

If so, are you new to the palliative care discipline?

Conference fees have been set in US dollars as listed on the Fees page here.

Please note that early registration closed

Please choose registration type/s

Conference

Pre-conference workshops

Gala Diner

Grand Total

Excludes transfer charges.

For payments using Visa/Master card/American express on line, please select Visa/Master/American express Card
For payments using PayPal pay or Card payments, please select PayPal
For payments to our bank account via a direct transfer or over the counter payments, please select Bank Transaction. Early registration payments are to be made no later than 30/06/2019.
For payments to our bank account via a direct transfer or over the counter payments, must include Bank Transaction Fees dependant on your respective bannk.
For payments that are to be made by a sponsor, please select Sponsored Delegate.

Select your prefered mode of payment.

Options *

Visa/Master/American Express PayPal Bank Transaction Sponsored Delegate