AFRICAN CIVIL AVIATION

COMMISSION

COMMISSION AFRICAINE DE

L'AVIATION CIVILE

REGISTRATION FORM / BULLETIN D'INSCRIPTION

1. Name / Nom:Mr. / Mrs. / Ms. / Other

First Name/Prenom Middle Name Last Name/Nom

2. Title/Position:

3. State/Organization/Company:

4. Mailing Address/ Adresse:

5. Telephone Number:

Fax Number:

E-mail:

Date: Signature:

African Civil Aviation Commission (AFCAC) Bo. Box: 8898

Dakar-Yoff Senegal

Tel: +221 33 859 88 00 Fax: +221 33 820 70 18

— END —

After completing this form please email it to / Après avoir rempli ce formulaire veuillez l’envoyer à

PLEASE COMPLETE THIS FORM LEGIBLY AND IN CAPITAL LETTERSVEUILLEZ REMPLIR CE FORMULAIRE LISIBLEMENT EN MAJUSCULES

(secretariat@afcac.org)

Capacity Building Workshops on Economic Oversight and Regulation for Sustainable Development of Air Transport in Africa