APPLICATION FORM - African Conference on Social Aspects of HIV/AIDS Research
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1st - 4th September 2002
Johannesburg, South Africa
Herewith the application form for the above conference:
APPLICATION FORM
Prof/Dr/Mr/Ms.
Last Name
First Name Middle Initial Degree(s)
Title or Position
Institution or Organization
Street Address:
City:
Country:
Telephone: Fax:
E-mail:
PRESENTATION PREFERENCE ( Please tick applicable)
[ ] I plan to make a paper presentation
[ ] I plan to make a poster presentation
Running Title
SPONSORSHIP ( Please tick applicable)
[ ] I have own sponsorship
[ ] I am still to find sponsorship to attend
Other
To obtain more details on the Conference please fill in
the form above and return it to the Organizing Secretariat
at the following addresses:
Dr Steven Chandiwana,
Director, Blair Research Institute
PO Box CY 573, Causeway
Harare, Zimbabwe
Tel: +263-4-703-525
Fax: +263-4-253-979 or 870-403
mailto:chandiwana@blair.co.zw
ormailto:igha@icon.co.zw
OR
Dr. Olive Shisana
Executive Director
Human Science Research Council
Social Aspects of HIV/AIDS and Health
14th floor, 69-83 Plein Park Building
Plein Street
Cape Town 8001
South Africa
mailto:oshisana@hsrc.ac.za
or
mailto:olive.shisana@hixnet.co.za
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