SASREG 2015
Social Evening Form

IMPORTANT: Please click here if you're travelling to South Africa with your Child / Children

To register, kindly complete one form per delegate.

DELEGATE INFORMATION

Title: Last Name:
First Name:
(for badge)
Middle Name:
Nationality: Invitation Letter Required: Yes / No
Do you agree that your name and email address can be given to sponsors of the congress: Yes / No
This is my:
(please select)
Private / Institution    
Institution Name: Institution Vat Number:
Department: Contact Person's Name:
Address: City:
State/Province: ZIP/Post Code:
Country:
Telephone:
(Country code/city code/number)
Fax:
(Country code/city code/number)
E-Mail: Mobile/Cell Number:
SASREG Membership Number:    
Special Dietary Requests:
Vegetarian: Yes / No / Other If other, specify:
Other Requests
Other Request:    

A - SOCIAL EVENING
Code (Office Use Only)

Fees - South African Rand (ZAR) Only (incl. 14% VAT)

Category
Cost
No. of
Persons /
Days
Amount
Social Evening
(Includes meals, snacks, drinks)
200
TOTAL: A - Social Evening

TOTAL AMOUNT PAYABLE

I, the undersigned, do hereby authorise Turners Conferences to debit my credit Card for the following amounts:
(please fax a copy of the front and back of your credit card to Turners Conferences)

A Social Evening
GRAND TOTAL:

PAYMENT DETAILS

Please select your payment option below.

When processing your payment by bank draft please allow additional funds to cover bank charges. If short payments are received they will be for your account.
Option 1
Bank Transfer
You must specify your name and SASREG2015 on your bank transfer. Forward to:
Account Name:Turners Conferences & Convention Pty Ltd - SASREG2015
Bank:First National Bank
Account No.:6253 524 7333
Branch:Durban Main Branch
Branch Code:221426
Swift No.:FIRNZAJJ
(Please fax a copy of your transfer to Turners Conferences +27 31 368 6623)
Final date for Bank Transfer payments will be 26 October 2015.
Option 2
Credit Card
Please complete the following authorisation for Turners Conferences to debit your credit card.
A clear photocopy of both sides of the credit card is required for bank approval and verification

Credit Card Type:
Credit Card Number
Expiry Date
Cardholder's Name
3 Digit no. on reverse side where applicable

Please complete this booking form and submit it to the Turners Conferences:

Turners Conferences and Conventions (Pty) Ltd
PO Box 1935, Durban, 4000 South Africa
Telephone: +27 31 368 8000
Fax: +27 31 368 6623
Email: gills@turnergroup.co.za

All transactions are conducted in terms of Turners Conferences standard conditions of trading. They are published on the Turners Conferences website & available on application.
Without the complete documents, we are unable to process your booking.

Your booking will only be confirmed once payment has been received.

Type this number into the box alongside: