2026 Harare, Zimbabwe Symposium Registration Form - International Center for Law and Religion Studies

Personal Information

Honorific

Salutation (e.g., Mr., Ms., Mrs., Dr., Prof., Rev.)

Given Names(Required)

Middle Name

Surname or Family Name(Required)

Full Name (as you would like it to appear on the program)

Gender(Required)

Nationality

Religious Affiliation

Religious Position

Institution Name(Required)

Institution Department

Position(Required)

Contact Information

Preferred Phone (include country and area code)(Required)

WhatsApp Number (include country and area code)(Required)

Preferred Email(Required)

Alternate Email

Institution/Work Address

Address Line 1

Address Line 2

City

State/Province

Postal Code

Country(Required)

Assistant Information

Assistant Name

Assistant Work Phone

Assistant Email Address

Registration

Other Special Needs

Dietary Restrictions(Required)

Language

Interpretation Language

Primary Language

English Fluency

Personal Information

Birthdate (Day/Month/Year)

Do you live locally?

Travel Information

Preferred Airline

Preferred Seating

Frequent Flyer Number (if available)

Known Traveler Number

Arrival Travel Information

Departure City(Required)

Departure Airport(Required)

Departure Date

(Note: ICLRS cannot pay for or arrange accommodation prior to January 16, 2026 at 3:00pm)

Return Travel Information

Return Destination(Required)

Return Airport(Required)

Return Date

(Note: ICLRS cannot pay for or arrange accommodation prior to January 16, 2026 at 3:00pm)

Passport Information

I have uploaded a copy of the personal photo page of my passport.(Required)

Full Name on Passport(Required)

Passport Number(Required)

Passport Issue Date

Passport Expiration Date

Bio

Please write a brief biography in paragraph form (limit to 150 - 200 words)(Can cut and paste from another document)(Required)

Guests

Accompanied by spouse/guest?

Please note: Guest travel and additional hotel room costs are paid by the guest and not by the conference organizers.

Spouse/Guest's Given Name(s) (if attending)

Spouse/Guest's Surname or Family Name (if attending)

Will the delegate be sharing a hotel room with their guest or does the guest need a separate hotel room?

Please select the number of beds required for your hotel room

Other

I have uploaded a high-resolution headshot of myself(Required)

I am willing to receive further communications from the organizers (e.g., program information, flight arrangements, etc.)(Required)

Link: 2026 Harare, Zimbabwe Symposium Terms and Conditions

Consent(Required)

I agree to the above terms and conditions relating to the event.