KNOWLEDGE BOX

REGISTRATION FORM

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Name: Email: Comment:

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First Name *

Last Name

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ex) Pisces

Birth Year (YY) *

ex) 85

Country *

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Please select one or more bursaries:

Tree Lion & Rhino Conservation
Urban Poverty Intervention Initiative
Primate Conservation Community Partnership

Which bursary tier(s) would you like to support?

Bronze
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Platinum
Diamond
Red Diamond

How many pupils do you wish to sponsor?

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4
5
Other

Which bursary tier(s) would you like support?

Bronze
Silver
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Platinum
Diamond

Please Select Number of Recipients:

1
2
3
4
5
Other

Please Select Bursary:

Primate Conservation Community Partnership
Tree Lion & Rhino Conservation
Urban Poverty Intervention Initiative

Please Select Bursary Tier(s):

Bronze
Silver
Gold
Platinum
Diamond