Please Send Your Completed Registration Form To

REGISTRATION

BEYOND 2010: 4 & 5 MAY 2010

PLEASE SEND YOUR COMPLETED REGISTRATION FORM TO:

FAX: 086-564-3969 / EMAIL:

DELEGATE DETAILS

NAME OF ORGANISATION:
POSTAL ADDRESS:
AREA CODE & TELEPHONE NO: / AREA CODE & FAX NO:
1 NAME: / 2 NAME: / 3 NAME:
SURNAME: / SURNAME: / SURNAME:
DESIGNATION: / DESIGNATION: / DESIGNATION:
TEL. NO: / CELL NO: / TEL. NO: / CELL NO: / TEL. NO: / CELL NO:
E-MAIL: / E-MAIL: / E-MAIL:
SPECIAL DIETARY REQUIREMENTS / SPECIAL DIETARY REQUIREMENTS / SPECIAL DIETARY REQUIREMENTS
Please indicate below with an X which Focus Group Session you will be attending:
MASTER CLASS STREAM 1: / MASTER CLASS STREAM 2: / MASTER CLASS STREAM 3:
MEDICAL CLINICIANS & THERAPISTS / EDUCATORS & EDUCATIONAL INSTITUTIONS / WORKPLACES, HR PRACTITIONERS, SDFs & TRAINING PROVIDERS

REGISTRATION FEE: R 2 700.00 (Excl. Vat) R3 078.00 (Incl. Vat)

SPECIALRATEFORSCHOOLS & EDUCATORS: R 2 400.00 (Excl. Vat) R 2736.00 (Incl. Vat)

/ SERVICES SETA SPONSORED STAKEHOLDERS: To qualify for your Services SETA sponsored fee, please include your SDL number or SDF / Assessor ID Number here:

PLEASE NOTE: On receipt of this registration form, an invoice with payment details or sponsorshipconfirmation letter will be sent to you with full event particulars.

Payment needs to be made prior to the event in order to confirm your booking.

AUTHORISATION:

NAME: / DESIGNATION:
SIGNATURE: / DATE: / ORDER NO:
VAT: NO:
I hereby authorise the registration of the above Delegate/s for the Beyond 2010 Conference. I accept the Terms & Conditions of the Registration & Cancellation Policy, and understand that Delegates are required to cancel in writing no later than 5 working days prior to the event if they can not attend, failing which, the Delegate organisation will be liable for full payment of registration fees for no-shows. Delegate replacements will be accepted at any time.