Section A: Personal Details

Full Name:

Job Title / Position:

Organisation / Company:

Sector (HR / Legal / Trade Union / SOE / Gov’t / Other):

Email:

Phone (WhatsApp preferred):

Section B: Participation

Attendance Type (tick):

Full Summit (5 days)Selected Day(s)

If Selected Day(s), please specify:

Do you wish to attend the CEO Breakfast (25 Nov, 07:30–09:30)?

Yes (M1200.00 per person)No

Dietary Requirements:

Accessibility Needs (if any):

Tshirt Size:

Section C: Registration Fees

• Standard: M1000.00

• Group Discount (5+ delegates): 5% off

• Students/Youth (limited seats): M500.00

Payment Method:

Bank TransferMobile Money (Mpesa/Ecocash)Other

If Other, specify:

Section D: Consent & Acknowledgement

I consent to my details being used for Summit logistics and communication.

I agree to abide by the Summit’s Code of Conduct.