Virtual Attendees Registration Form

Smart Health Summit

Please fill out the following form to help us process your registration.

Ticket ID

Ticket Title

Price of Ticket

Event *

Type of Registrant *

First Name *

Enter your first name

Last Name *

Enter your last name

Work Email *

Enter your work email. Please don't enter a Gmail, Yahoo, Hotmail address.

Work Phone *

Enter your work phone number. We'll typically use this for any urgent communication going forward.

Company *

Enter the name of the company you work for.

Role *

Enter your role in the company you work for.

Industry *

Enter the name of your industry, e.g. Space Exploration, Telecommunications, Fintech, Robotics, Textiles, etc.

By registering your interest to attend this event you agree to our privacy policy.

GDPR Consent *

By registering you also agree that dx⁵ (formerly CIO Africa) and this event's partners and sponsors will contact you from time to time with information about its own or clients' products and services. How would you like the host, partners or sponsors of this event to contact you?

Email
Phone

Joburg Summit Ticket – Virtual

Price: USD 0.00 (exc. VAT)

Total Price: USD 0.00