Delegate Registration Form

Please fill out the form below to register for the conference

NB:To ensure accurate and prompt processing of your payment confirmation, please be sure to include the following reference number in the subject line of your email:

Reference Number: # Check Accommodation : View

TITLE:

NAME:

SURNAME:

GENDER:

INSTITUTION:

POSITION:

E-MAIL:

TELEPHONE:

COUNTRY:

ORGANIZATION CURRENT STATUS:

HOTEL NAME:

DATE OF ARRIVAL:

TIME OF ARRIVAL:

ARRIVAL AIRLINE/ FLIGHT NUMBER:

DATE OF DEPARTURE:

TIME OF DEPARTURE:

DEPARTURE AIRLINE/ FLIGHT NUMBER:

Excursion (Optional)

Would you like to go for the excursion?

FOREIGN PAYMENTS – (PAYMENTS FROM OUTSIDE GHANA)
Intermediary Bank: CITIBANK
Address: 111 WALL STREET, NEW YORK, NY 10043, UNITED STATES OF AMERICA
Swift Code: CITIUS33
Beneficiary Bank: ECOBANK GAMBIA LIMITED
Swift Code: ECOCGMG
For Further Credit To:
Account Name: WAICA BANJUL 2026
Account Number: 6254507953
BBAN: 008101625450795390
Address: 42 KAIRABA AVENUE SERREKUNDA THE GAMBIA

LOCAL PAYMENTS – (PAYMENTS WITHIN GHANA)
Account Name: West African Insurance Companies Association
Account Number: 2441001140913
Swift Code: ECOCGHAC
Name of Bank: Ecobank Ghana
Bank Branch: Head Office
Address: 19 Seventh Avenue, Ridge West
P.O. Box AN 16746
Accra- North
Ghana

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