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Mining Indaba Covid Test Booking Form
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First Name
*
Your answer
Last Name
*
Your answer
Passport Number
*
Your answer
Gender
*
Male
Female
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Date of Birth
*
MM
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DD
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YYYY
Contact Number (Whatsapp Preferred)
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Your answer
Email Address for Correspondence & Results
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Your answer
Test Option
*
Pre Conference
Travel
Both Pre Conference and Travel
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