1.

SAPSAC 15TH ANNUAL NATIONAL CONFERENCE ON CHILD ABUSE

10-12 NOVEMBER 2014

CSIR INTERNATIONAL CONVENTION CENTRE PRETORIA

REGISTRATION FORM

FINAL DATE FOR REGISTRATION24 OCTOBER 2014

Please complete and fax or email PAGE 1with proof of payment to 086 629 6234 or Tel 012991 0718 (8:30-13:00)

1. PERSONAL DETAILS

Title, Name and Surname
(as appearing on certificate)
Profession
HPCSA/SACSSP Number
Organization /Private Practice
SAPSAC Membership number (If applicable)

2. CONTACT DETAILS

Day time phone and code
Mobile Phone
Email Address

3. REGISTRATION FEES. PLEASE INDICATE AMOUNT PAYABLE WITH AN X. (BANKING DETAILS AND TERMS AND CONDITIONS ON PAGE 2)

SAPSAC Members / Non- Members / Day Fees / Groups of more than 10 / Groups of more than 20 / Groups of more than 30
R 2350.00 / R3150.00 / R 1050.00 p.d. / R 2850.00 p.p. / R2750.00 p.p. / R2650.00 p.p.

Special fees for undergraduate studentsare available. Please send an email to

4. CATERING AND ATTENDANCE (PLEASE INDICATE YOUR ATTENDANCE WITH A YES OR NO)

CONFERENCE 10 NOVEMBER / CONFERENCE 11 NOVEMBER / CONFERENCE 12 NOVEMBER

Please take note that we can not cater for special dietary requirements. (Extra costs are involved, not covered by the registration fees) Please send an email to if you have any enquiries in this regard.

The Committee of the SAPSAC Annual Conference (referred to as the "Conference") will do everything possible to ensure that your attendance at the Conference will be as comfortable as possible. The Conference, any member and/or members of its committee and its appointed agents or either subcontractors, act on the basis that they attend to the arrangements of the Conference for the convenience of the Conference delegates. They perform all tasks on condition that the Conference, any member or members of its committee and appointed agents or subcontractors, cannot be held responsible for any loss, damage or inconvenience (however arising) experienced by the conference delegates neither can they be held responsible for unforeseen partial or total cancellation of the event. The programme is subject to change without notice.

I took note of the above as well as the terms and conditions regarding registration, payment and cancellation on page 2. I also take note of the fact that if my employer/organization/department default on payment that I will be held personally responsible for payment of the registration fees.

Signature:Date:

(If emailed please type name and surname as confirmation of acceptance of terms and conditions)

2.

5. ACCOMMODATION (Accommodation to be arranged by delegates)

Hotels to consider (contact the Hotels directly)

Holiday Inn Garden Court (Pretorius Street): 012432 9600

Town Lodge (Atterbury Rd) 012 348 2711

City Lodge (Lynnwood Rd) 012 471 0300 (Nearest to Venue)

6. AIRPORT SHUTTLE SERVICE (Airport Transport to be arranged by delegates)

Coreen: 012 430 3571/ des_amis@worldonline .co.za

Menlyn Transfers and Tours: 012 3488716/082 576 7040/

Kwathlano 0861 428 8364/reservations @kwathlano.co.za

Airport Shuttle: 0761443442/

7. PAYMENT OPTIONS: DIRECT DEPOSIT OR EFT

Your conference fee should be deposited into the SAPSAC bank account.

Bank: Nedbank

Branch: Hatfield

Branch code: 160 245

Account No: 1634 025997

Reference: Conf.14+ Name and Surname (Please indicate it on the Deposit Slip/Electronic Transfer)

Please fax proof of direct deposits or electronic transfers to include name and amount deposited to: 086 629 6234

WITHOUT THIS INFORMATION WE CANNOT CONFIRM YOUR REGISTRATION.

8. SAPSAC'S TAX CLEARANCE NUMBER: 0064/2/2013/0002605172

9. CANCELLATIONS AND REFUNDS

  • Cancellations received before17 October 2014will incur a 50% cancellation fee. No refunds will be paid if cancellations are received after 24 October 2014. Substitutions are welcome, provided they are given in writing and on an official letterhead where applicable.

10. TERMS & CONDITIONS

  • No private registration can be confirmed without full pre-payment.
  • Registration of delegates by Government Departments will only be processed on receipt of payment or Purchase Order Number. Name and all contact details of person responsible for payment need to provided no registration will be confirmed without it
  • If you require an invoice, please contact us at
  • No walk-in registrations can be accommodated
  • Should SAPSAC not receive your payment, or proof thereof, by Friday 24 October 2014 your registration will automatically be cancelled.

CONFIRMATION OF REGISTRATION

Please phone 012 991 0718 (8:30-13:00) to confirm that your registration form has been received, even if it has been submitted by a training co-coordinator or departmental official. Responsibility cannot be taken for registration forms not received by the conference secretariat. Delegates will not be accommodated at the conference without prior registration.