Advanced Phylogenetics Workshop Registration (2019)

Advanced Phylogenetics Workshop Registration Form

2019
Attendee information
Please select the workshop that you want to attend *
Full Name *

Prefix First Name Last Name
E-mail (attendee) *
example@example.com
Nationality *
This information is required for funding reports
Position *

MSc student PhD student Post-doc / Research fellow Lecturer Researcher
Name of University or Institute *
Research group name *
Department *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number *

Area Code Phone Number
Supervisor information

Please provide your supervisor's information if relevant
Name

Prefix First Name Last Name
Name of University or Institute
Department
E-mail (Supervisor)
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number

Area Code Phone Number
Additional information

Please provide us with the following information
Level of experience in phylogenetic methods. *
Your expectation of the workshop. *
Indicate any dietary requirements (e.g. Vegetarian)
Payment for the workshop
Payment for attendees outside the University of Pretoria

An invoice will be made out to the attendee and the purchase order should be e-mailed eva.muller@fabi.up.ac.za and heidi.roos@fabi.up.ac.za before the workshop. Please take note of the closing dates for payment as indicated on the workshop web-page.
Please provide a name and address to whom an invoice should be made out
(e.g. University of Pretoria, Private bag X20, Hatfield, 0028, South Africa)
Payment for attendees from the University of Pretoria

Payment can be done by internal electronic transfer to the following cost centre: A0Z525.
Please contact Prof Martin Coetzee or Ms. Heidi Fysh if you did not receive an email in person from them confirming your registration (please see contact details on the workshop web-page.
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Advanced Phylogenetics Workshop Registration Form

Attendee information

Supervisor information

Additional information

Payment for the workshop

Payment for attendees outside the University of Pretoria

Payment for attendees from the University of Pretoria