The Venue Is Stellenbosch University, Stellenbosch, South Africa

Registration Form

The venue is Stellenbosch University, Stellenbosch, South Africa.

Please visit the symposium website for additional information.

Please complete and return this form along with payment to the Symposium co-ordinator, Mr Deon Malherbe at either: Department of Forest and wood Science, Private Bag X1, Matieland. 7602. Or Fax: +27 21-808 3603 or E-mail:

No cancellations, refunds or late registrations will be accommodated after 9 February 2015 (see website for relevant deadlines)
1. DELEGATE CONTACT DETAILS
Last Name: / Title (e.g. Mr/Mrs/Ms/Dr/Prof):
First Name:
Name on Badge:
Organisation:
Position:
Mailing address:
Suburb/Town:
Country/State:
Telephone (business): / Fax
Telephone(mobile/cell) / Email:
2. SPECIAL REQUIREMNETS:
Please note any specific dietary or other requirements (e.g. vegetarian meals or wheelchair access)
3. Symposium registration COST
Early registrants (delegates): ZAR 5 500
Cost per registered student: ZAR 4 500
Late registrants (including students): ZAR 6 000
Post-conference tour (single): ZAR 7 000
Post-conference tour (sharing): ZAR 6000

PAYMENT DETAILS

(Foreign payments)

Please deposit amount payable into the following account and

Send remittance to Mr Deon Malherbe.

Fax: +27 21 808 3603 or E-mail:
Account name:
Bank:
Branch code:
Account number:
Swift Code: / University of Stellenbosch
FIRST NATIONAL BANK
204109
621 0717 7083
FIRNZAJJ796
Amount Paid: / Date Paid:
Reference: R1078/(surname)
Method of Payment:
Cheque payment Money order or bank draft

I ______, the undersigned wish to register for the Dryland Forestry Symposium, Stellenbosch, and understand the registration terms and conditions as outlined on the Symposium’s webpage:

Date: ______Signature: ______

For office use only:

Invoice Issued / Confirmed Receipt of Payment / Confirmed Registration