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Registration Form

HiETeC-2024 Attendees Registration Form

Name of participant

Title

First Name

Last Name

Nationality

Institution / Organization

Contact information of the participant

Email

Phone Number

Participant type

Mode of attendance

Please fill your Emergency Contact Information below

Name

Emergency phone number

Relationship

Payment mode

Payment details

MPESA PAYMENT
Mpesa Paybill: 209800
Ac No: HiETeC2024-applicant name

BANK PAYMENT
Beneficiary Bank: Co-operative Bank (K) Ltd.
Physical Address: Co-operative Bank House Nairobi, Kenya.
Branch: Athi River
Acount Name: HiETeC2024-applicant name
Sort Code: 11033
Swift Code: KCOOKENA
Beneficiary A/C No: 01120065209800 (Kenya Shilling Account)
02120065209800 (Dollar Ac)
Bank Address: P. O. Box 321(00204)
Town: Athi River
CORRESPONDENT BANKS (note: Only use this when it is a requirement by your bank)
US Dollar Remittances: Standard Chartered Bank, NEW YORK Swift code SCBLUS33
Euros remittances: Deustsche Bank AG Frunfurt Swift code DEUTDEFF Sterling
Pound Remittances: Standard Chartered Bank PLC, London swift code SCBLGB2L