13th Conference registration

Personal details

Title

First Name

Surname

Preferred Badge Name

Email address

Phone number registered on WhatsApp (eg: +27...)

Role

Site

Citizen of which country

Current country of residency

Biography (maximum 250 words)

Recent headshot for booklet

One file only.
2 MB limit.
Allowed types: jpg, jpeg, png.

Would you want to attend in-person or virtual?

SickleInAfrica site you are interested in and can legally work from

Do you require a flight?

Passport Number

Date of Expiry

Please attach your passport copy

One file only.
2 MB limit.
Allowed types: pdf.

Country which issued the passport

City and Airport of Departure

Check-in date

Check-out date

If you would like to arrive and/or depart on different dates to those mentioned above, please provide us with preferred dates

Dietary Requirements

Days of attendance

3rd June 2025

4th June 2025

5th June 2025

6th June 2025