Oxford Institute of Population Ageing

23-25 April 2014 Workshop

and 28 April-1 May Training School

‘The Fertility Transition in Africa’

REGISTRATION FORM

Deadline: 20 March 2014

Deadline for registration and application for a bursary: 21 February 2014

Please fill in the information below and submit with a bio-sketch:

First Name: ______

Surname:______

Institution/Organization______

Position______

Mailing Address: Home ___ Work ___ (please tick/X relevant field)

Address______

______

City:______State/Province:______

Post Code: ______Country: ______

Tel Number: Work ______Home or Mobile: ______

Fax Number: ______

Email Address:______

Nationality: ______

Will require Visa: yes ______no ______(Please note: authority approvals of visa applications often take several weeks)

I am interested primarily in attending:

Workshop and Training School (23 April – 1 May) ______

Only Workshop (23-25 April) ______

Only Training School (28 April – 1 May)______

If considered, I would require accommodation: yes ______no ______

If yes, dates for which accommodation is requested:______

Intended source of funding (please tick/X the relevant field):

Self financing ______

Require support for: entire fee ______partial fee ______

Would you like to be considered for a bursary: yes______no ______

If yes, please provide a CV and an application letter stating financial reasons for support request.

If you wish to submit a paper/presentation, please send a 250 words abstract.

Registration fees:

£400 - Workshop Only (23-25 of April) – includes 2 nights’ accommodation, 2 dinners, 3 lunches, refreshments, workshop materials

£600 - Training School Only (28 of April -1 of May) – includes 4 nights’ accommodation, 4 lunches, refreshments and school materials

£1200 - Workshop and Training School (23 of April – 1 of May) – includes 8 nights’ accommodation, 2 dinners, 7 lunches, refreshments, workshop and school materials

Registration fee paid by:

Check______

Debit/Credit Card______(please submit details to Katia Padvalkava)

Please submit application to:

Katia Padvalkava

Research Officer

Oxford Institute of Ageing

66 Banbury Road

UK - Oxford OX2 6PR

Tel: +44 1865 612810

Email: