REGISTRATION FORM
Legal Office Administration and Client Care (e-Course) / Please email your form and proof of payment to. NB:Please do not fax the form or use any other email address.
Contacts: Grace Mukuru(Tel +27 (0)12 441 4612)
Stephne Pieterse (Tel +27 (0)12 441 4607)
INSTRUCTIONS ON HOW TO COMPLETE THE FORM
  1. Save the form on your computer and then type your details directly onto the form where indicated-.
  2. Where a blockappears,please select the correct block to look like this .
  3. Print out the form and sign where indicated.
  4. Scan the form and email it to .
  5. LEAD will acknowledge receipt of the form within 5 working days. Contact ASAP if you do not receive this acknowledgement.
  6. If you have any problems completing the form, please contact Grace Mukhuru on +27 (0)12 441 4612.

YOUR DETAILS
Surname: / First name:
ID number: / Position: / Title:
Firm/company: / Town/city: / Gender: F M
Tel: () / Fax: ()
Cell: / Email:
Postal address: / Postal code:
Home address: / Postal code:
Firm/company docex address: / Race (for reporting reasons):
COURSE INTAKES AND DATES (Please indicate)
First intake: 5 March 2012 – 5 April 2012 (closing date for registration: 17 February 2012)
Second intake: 1 September 2012 - 30 September 2012 (closing date for registration: 10 August 2012)
PAYMENT DETAILS(No registration will be confirmed if the proof of payment has not been received.)
Payment by Credit Card:Card type: MasterCard Visa Amount: R450
Budget facility to be used? No Yes Number of months: Card expiry date: /
Card holder’s name: Card No:
Signature: Date: //2012
I confirm that I have read the Terms and Conditions of this course as available on the LEAD website.
Payment by cheque: (NB: payable to: Law Society of South Africa) Amount: R 450
Payment by electronic funds transfer (EFT):Amount: R 450
Account Name:Law Society of South AfricaBank:FNB Pretoria
Account:6200 9641 079Branch Code:251445
Reference:TEL NO/FIRM/NAME/CELL/REF: E-OACC
Legal Education and Development (LEAD) │ P O Box 27167, Sunnyside 0132│ Docex 227, Sunnyside
E-mail: │Website: Tel: +27 (0)12 441 4600 (switchboard)

LSSA LEAD SEMINAR 2011 Page 1 of 2