REGISTRATION FORM
PERSONAL INFORMATION
Family Name:
First Name:
Country of Citizenship:
Organization:
Address:
Zip Code:
State:
Country:
Title/Position:
Gender:
Telephone:
FAX:
Email:
AFFILIATION
[Please select that applys]
THEMATIC INTEREST
[Please check all that apply]
Collaborative actions on disasters Disaster mainstreaming
Effective Disaster management plans  
Establishing emergency funds  
Forecasting disasters  
Disaster risk management
SUMMARY OF REGISTRATION FEES
Early (by November 2008)  
USD $200  
Payment options Direct Deposit
Bank details Account Name: UGANDA COALITION FOR CRISIS PREVENTION
Bank: Stanbic bank
Branch code: 1008
Account No: 0140012487902
Swift Code: SBICUGKX
PRACTICAL INFORMATION
Would you need an invitation letter for the visa to Uganda?
Please return this form to: Secretariat of the International Workshop
Uganda Coalition for Crisis Prevention
Plot No. 27 Nakasero Road
P. O. Box 29578 Kampala, Uganda 		Email: info@uccpuganda.org.
Fax: +256-414-230748