Registration form

Registration form
MICROFIN CONSULT LIMITED
WORKSHOP REGISTRATION FORM
Kindly complete in full (in legible handwriting or typed) and submit through:
[email protected]
Location
Business Planning and Budgeting using Microfin (Excel-based
budgeting tool)
Windy Lodge, Winneba
Date:
7th – 11th March, 2017 (All days inclusive)
Time:
8:30am-5:00pm
Closing Date for application
30th December, 2016
Payment deadline
15th January, 2017
Workshop Title:
PERSONAL INFORMATION
Title:
Last name:
First name:
CONTACT ADDRESS
Telephone:
Fax:
Email:
MORE INFORMATION
Job Title:
Name of RCB/MFI:
Geographical area of operation:
Nationality:
Gender: Male
Female
What are your reasons for applying for this workshop?
Please state in the box below your expectations at the end of the workshop.
Workshop Fee:
Subsidized Fees:
Representation
Residential
(USD)
1,500
(100)
(250)
International Participants
Early Booking Discount*
Partial Scholarship**
*Only Available if payment received by 30 Jan 2017
**Available on first come, first serve basis, and based on the answers to the questions above
Payments should be made to the Account below:
Account Name: Microfin Consult Limited
Name of Bank: Unibank, Kaneshie Branch-Ghana
Account Number: 0410141524716
Swift Code: UBGHGHAC
Registration:- Completed registration form should be set via email to : The Programme Coordinator
[email protected]
I confirm that the information which I have given in this application is complete and true.
Signature
Date
Contact the following for further enquiries
Cassandra Okudzeto – Training Coordinator - +233(0)24 245 3774
Ishmael Kwesi Otchere – Managing Consultant-+233(0)24 341 2668
Email: [email protected]
Website: www.microfinconsult.com
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