Guest Registration — MOU Signing Ceremony
Inmate Innovation Initiative (III) — Cells to Success
Delegate Registration Form
Date: 28 April 2026. Venue: Gweru Correctional Facility (Whawha Young Offenders). Time: 10:00 – 14:00 hrs. Kindly complete this form for security clearance and event registration. All guests must comply with ZPCS protocols
Section 1: Personal Information
Full Name
*
Type in your name.
Title or Position
*
Type in your title or position.
Organization/Institution
*
Type in your Organization/Institution
Email Address
*
Type in your email.
Phone Number
*
Type in your Phone Number including country code.
Section 2: ATTENDANCE DETAILS
Type of Attendee
*
Please Select
WIT Delegate
ZPCS Official
Gweru Polytechnic Delegate
Government Representative
Industry Partner
Media
Guest
View Course Structure & Catalogue for Details
Would you wish to attend with someone else?
*
Please Select
Yes i would wish to bring in some one
No, i will be attending by myself
If yes, share the details of the members?
Street Address Line 2
City
Postal / Zip Code
Section 3: Dietary Requirements (Lunch Catering)
Do you have any dietary requirements?
*
Please Select
No dietary restrictions
Vegetarian
Vegan
Halal
Kosher
Gluten-free
Lactose intolerant
Other (please specify)
If Others, please specify
Do you have any food allergies?
*
Please Select
Yes
No
If Others, please specify
If yes, please specify allergies
(dietary restrictions, mobility assistance, etc.)
Do you have any suggestions to enhance the conference? (Optional)
(Please specify any ideas, speakers, exhibitors, or topics you'd like to suggest)
Section 4: DECLARATION
Agreement to Security Protocols
I confirm that I will carry valid identification
I agree to comply with ZPCS security regulations
I understand that unauthorized photography is prohibited
During this event, photographs and videos may be taken for documentation, media, and publication purposes (including reports, social media, and promotional materials).
*
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