26TH AIO AFRICAN REINSURANCE FORUM REGISTRATION

26TH AIO AFRICAN REINSURANCE FORUM REGISTRATION

Please register by filling out the form below.
Event Date: 01st -05th October 2022

Event Venue : HOTEL du 02 FEVRIER , Lomé-TOGO
Mode of Attendance*

In-PersonVirtual
Categories*

AIO MemberNon-MemberSupervisory Authority/AIO MemberSupervisory Authority/Non-MemberAssociation/Training InstitutionLocal Delegates - TogoMediaSponsorComplimentarySpeakerLocal Organising CommitteeOrganizerVIP/Guest
Full Name*

PrefixFirst NameLast Name
E-mail*
example@example.com
Phone Number*

Country code Phone Number
Country*
Company Name*
Job Title*
Branch of Activity*

InsuranceReinsuranceInsurance BrokersReinsurance BrokersAssociationSupervisory AuthorityPublic InstitutionOther
Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you have an accompanying person? (Spouse or Child)

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Accompanying Person E-mail Address
example@example.com
Accompanying Person Name

First NameLast Name
what's your Relation?
TOTAL ($)
Language*

EnglishFrench
Passport Number*
Flight Details

Fill in your flight plan below
Arrival Flight date/Time

MonthDayYear
Date
Hour MinutesAM/PM Option
Arrival flight number
Departure flight date/time

MonthDayYear
Date
Hour MinutesAM/PM Option
Departure flight number
Airline company
Payment Status
Amount Paid ($)
Balance Remaining ($)
Should be Empty:

Flight Details