Liberation Movement Summit 2024 Pre-Registration Forms

South African’s National Liberation Movement

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Pre-Registration Form

Instructions:
Complete the form below to pre-register for the Liberation Movement Summit 2024. Fields marked with (*) are mandatory. Please ensure that you upload all required documents before submitting the form.

Arrival date:6 December 2024
Departure date: 9 December 2024.

- Step 1 of 9

Section 1: Personal Information

Name (as it appears on your passport) *

First

Last

Title

Gender

Nationality *

Passport Number *

comply specify information

Date of Birth *

Organisation/Movement Represented

Position/Title in Organisation

Section 2: Contact Details

Email Address *

Phone Number (with country code) *

Emergency Contact Phone Number *

Emergency Contact *

Emergency Contact Name and Relationship

Section 3: Travel Information

Date of Arrival in South Africa

Date of Departure from South Africa

Port of Entry (e.g., OR Tambo International Airport)

Section 4: Accommodation

Do you require accommodation arrangements *

If Yes, Check-in Date

Check-out Date

Section 5: Dietary Requirements

Do you have any dietary restrictions? *

If Yes, please specify (e.g., vegetarian, halal, allergies)

Section 6: Translation and Accessibility

Will you require translation services during the summit? *

If Yes, specify the language required (e.g., French, Portuguese, SASL)

Do you have any mobility or accessibility requirements? *

If Yes, please provide details (e.g., wheelchair assistance)

Section 7: Document Uploads

Upload Passport Copy (PDF or JPG format, max size: 5MB) *

Upload Passport-Sized Photo (JPG format, max size: 2MB)

Section 8: Declaration

I hereby confirm that the information provided is accurate and complete. I agree to comply with all protocols and requirements of the Liberation Movement Summit 2024.

Signature (Typed Name)

Date *

NOTE *

Once submitted, you will receive a confirmation email with further instructions.
I will pick up my prescription

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