Onsite Payment Form

Full name*

First Last

Job Title*

Organization Name*

Write in full and do not provide an abbreviation

Email Address*

Enter Email Confirm Email

Please enter a valid professional email address. If you are applying on behalf of a colleague please ensure you insert his/her email address.

Ticket Category & Payment Amount*

Copy and paste the information sent to you by email.

By submitting this application, I agree that:*

My contact information will be safeguarded by the ICT4D Conference as identified in the ICT4D Conference Privacy Policy www.ict4dconference.org/privacy-policy. By submitting this form, I am requesting a code to use in the ICT4D Conference registration form and to follow the instructions emailed in March 2024 to come to the Alisa Hotel North Ridge on Monday, March 18, 2024, to pay the ticket amount in cash or by bank card. In return, ICT4D Conference will issue a participant name badge and provide access after payment.

I agree to all the above terms

Onsite Payment Form 2024