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Title * Mr.Mrs.Ms.Dr.Prof.
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Language * EnglishFrench (but fully conversant in English)French (and I would prefer translation services)Other
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Organisation Type * Social EnterpriseNGOCorporate/CompanyFoundationPublic institution/GovernmentAcademic InstitutionInvestorOther
Sector * AgricultureArts and cultureCitizen engagementEconomic developmentEducationEnvironmentFinancial servicesHealthHospitalityManufacturingMarketing and MediaNutritionSustainabilityTechnologyWomenYouthOther
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Please upload a heads and shoulders photo of yourself: (Minimum 200 x 200 pixels, maximum 1000 x 1000, no larger than 2MB) Upload file
I am a social entrepreneur and I want to exhibit (please note that this is strictly on a first- come, first-served basis, and places are limited. We will confirm with you if we are able to accommodate your request) *YesNo
I am a social entrepreneur and would like to participate in the pitch competition on Friday, 22 June *YesNo
I would like to attend the summit dinner on the first night (Wednesday, limited places) *YesNo
I require more travel information and/or a letter of invitation for a visa *YesNo
I am available for a media interview *YesNo
I would cover this subject matter:
I require disability facilities *YesNo
Please provide a 80-150 word biography of yourself (background, areas of impact) *
I will be attending for: * All 2 1/2 days (Wednesday to Friday) Wednesday Thursday Friday
Delegate fee * Self-funded at standard fee ZAR 3 000Funded by a corporate at a standard fee ZAR 3 000Self-funded at subsidised fee ZAR 1 500Funded by an NGO/organisation at subsidised fee ZAR 1 500Standard fee for one or two days only ZAR 2 000Subsidised fee for one or two days only ZAR 1 000I am a complimentary guest of AshokaI am a complimentary guest of the British Council
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