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					                                          Safer Internet Day

                                          5th February 2013
                                           Registration Form

Venue: Mahatma Gandhi Institute, Moka
Time: 9:00 am

Please note that the workshop is free of charge
   REGISTRATION
   Organisation

   Address

   Website

   PARTICIPANTS*

   Title (Mr, Mrs, Ms, Dr. ..)

   Full name of participant

   Designation

   Email

   Phone

   Fax

   Signature

   Date


* Organisations wishing to register more than 1 participant can make copies of the Registration form



  You are kindly requested to return the completed registration form to info@cert-
       mu.gov.muor by fax on 208-0119 at latest 4hFebruary 2013, 12:00 pm



         You may also download thisregistration form from the Safer Internet Day
                         2013websitewww.cert-mu.org.mu/sid


                                                    *******

				
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