Acc Stakeholders Platform Registration Form (#35)

Full Name

Gender

Male

Female

Organization/Institution Name

Which category describes you best?

Email address

Phone/Mobile

Country of Departure

If you need a referral visa to enter Tanzania, please provide your passport number to enable us prepare an invitation letter

Preferred language

English

French

Portuguese

Kiswahili

Do you have any disability or impairment that need special arrangement?

Kindly indicate if you will be travelling with a toddler/a minor

Please indicate if you are allergic to certain types of foods/drinks

Preferred payment method of the registration fee

Bank transfer

Western Union or Money Gram

Other Means

The requested information herein will be used for the purposes of the organization and managing of the Stakeholders’ Platform only.

REGISTRATION FEE: USD 350
FOR LOCAL CSOs IN TANZANIA & MEMBERS OF THE TANZANIA BAR ASSOCIATION USD 250

Registration fees should be made to the below bank account;

ACCOUNT NAME: AFRICAN COURT COALITION

BANK NAME: ABSA BANK TANZANIA LIMITED

TZS ACCOUNT NUMBER 4004910

USD ACCOUNT NUMBER 8008813

BRANCH NAME: 002-SOPA BRANCH

SWIFT CODE: BARCTZTZ CITY: ARUSHA

COUNTRY: TANZANIA

You can also send the registration fee through western union to the accountant: IRENE EDWIN MWASOTA

After making payment, please send the proof of payment to:

Irene Mwasota accountant@africancourtcoalition.org

And a copy to Rebecca Nyange admin@africancourtcoalition.org

NOTE: For any issues that arise while making payments and/or inquiries associated with payments, please contact Ms. Irene Mwasota for assistance at +255 743 110 417.

Stakeholders Platform Registration Form

Stakeholders Platform Registration Form

Thank you for your interest in participating in the African Court Coalition Stakeholders' Platform!