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On: Number of participants: Contact person: Telephone: Email: Preferred dates: Fee calculation (see subscription plan and fee schedule below): Gross fee payable (per table below) Net fee amount: Add 5% VAT: Amount payable: USD Cheque payment: Please issue cheque/bank draft in favour of PricewaterhouseCoopers Direct deposit or Electronic Fund Transfer Account name: PricewaterhouseCoopers Bank name: Standard Chartered Bank Bank address: 105B Ajose Adeogun Street, Victoria Island, Lagos Accou.

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