Event Registration

Participant Details

Salutation

First Name

Last Name

Email Address

Phone Number Please include country code Eg. (+962 xxxxxxx)

Organization

Job Title

Travel Information

Date of Birth

Passport Number

Country of Residence

Nationality

Will you be flying to Amman to participate in this conference?

Yes
No

If yes, will your organisation be covering the cost of these flights?

Yes
No

Will you require accommodation during your stay in Amman?

Yes
No

If yes, will your organisation be covering the cost of this stay?

Yes
No

Upload passport information page scan

Upload a current passport sized photo of yourself

Conference Information

Which is your preferred working language?

English
Arabic

Do you wish to make a presentation at the conference?

Yes
No

If yes, please provide a brief synopsis of your presentation: (max 300 words)

If yes, please provide us with a brief professional biography (300 words max)

Are you willing to act as a moderator or chairperson of a session?

Yes
No

Funding

The WANA Institute has a limited budget with which it can provide financial assistance to participants. Funding for flights and accommodation is prioritised for participants based on certain criteria, and not all funding requests will be accommodated.

Are you seeking funding support to permit your participation at this conference?

Yes
No

If yes, for which elements do you require support: (select all that apply)

Accommodation
Flights

Please provide any additional information about your funding request you feel relevant: (max 300 words)

Participant Details

Travel Information

Conference Information

Funding

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