WDA CONGRESS

Kramer Building, Middle Campus, UCT
08 September 2006 to 11 September 2006

 MAIN  |  GERMAN REGISTRATION FORM  |  CREDIT CARD FORM  |  ACCOMMODATION 

Registration Form

Title:
Name:
Surname / Family Name:
HPCSA No:
Organisation / Society:
Postal Address:
Postal Code:
Province:
Country:
Email:
Confirm Email:
Telephone:
Fax:
Mobile:
 
DIETARY REQUIREMENTS
Please indicate if you have an strict dietary requirements
Kosher Surcharge: R120
 None   Vegetarian   Halaal   Kosher 
 
Early Registration Cut Off Date: 30 June 2006
 
REGISTRATION TYPES Late Cost On Site Cost
Delegate Full (Fri, Sat, Sun, Mon) R1100
 
CONFERENCE TRANSPORT
If you require transport to/from the conference please select the days and the location from below:
Sat Transport from:
Sun Transport from:
Mon Transport from:
 
CONFERENCE EVENTS
08/09/2006
Name: Registration Cocktail Party
Venue: Kramer Building, Middle Campus, UCT
Start Time: 19h30
End Time: 20h30
Cost: Delegates R0 / Partners R120
Number Attending the Registration Cocktail Party    Fri
If you require transport please select where from:
 
10/09/2006
Name: Congress dinner
Venue: Moyo, Spier Estate, Stellenbosch
Start Time: 19h00
End Time: 22h30
Cost: Delegates R330 / Partners R330
Number Attending the Congress dinner    Sun
If you require transport please select where from:
 
11/09/2006
Name: African evening
Venue: German School
Start Time: 19h00
End Time: 22h30
Cost: Delegates R0 / Partners R0
Number Attending the African evening    Mon
If you require transport please select where from:
 
PAYMENT INFORMATION:
 
Local Delegates
  • Bank deposits (preferred method of payment): Please see banking details below and fax a legible deposit slip to +27 21 448 6263.
  • Electronic transfers: Please see banking details below and fax a legible deposit slip to +27 21 448 6263.
  • Cheques: Please see account name and address below under "Banking Details".
  • Credit cards: Please print the authorisation form, complete in full and return according to the directions provided.
Overseas Delegates
  • Credit cards: Please print the authorisation form, complete in full and return according to the directions provided.
  • Tele-transmissions (preferred method of payment): Please see banking details below, quote our Swift code (SBZAZAJJ) and e-mail or fax proof of payment to +27 21 448 6263.
 
BANK DETAILS:
Bank: Standard Bank
Branch: Mowbray Branch
Branch Code: 02-49-09
Account Name: Conference Management 03
Account Number: 071279024
 
CANCELLATION INFORMATION
Cancellations should be made in writing and mailed, faxed or e-mailed to Jolandi Ackermann at the address below. Refunds will be at the discretion of WDA 
 
AIRPORT TRANSFERS AND TOURS
For information or to book an airport transfer please contact:
Mpumalanga Tours, Robin Troup
Tel. +27 (0) 82 657 3443

Email: wildsafari@worldonline.co.za
 
FURTHER INFORMATION AND ENQUIRIES:
 

Jolandi   Ackermann

Tel: +27 21 406 6381
Fax: +27 21 448 6263
Email: Jolandi.Ackermann@uct.ac.za