ALLSA Congress

Online Registration



Personal Details

Title
Surname *
First Name *
Telephone *
Mobile *
E-Mail *
Fax
Postal Address
 
Code
Hospital / Company / Organisation
MP No.
Accompanying Person Name
Dietary Requirements

Registration Fees (Inclusive of Vat) • Early Registration Essential!
  Early before 15 March Late from 16 March – 9 April
 
ALLSA Members R2 000 R2 500
ALLSA Non-Members R2 200 R2 700
Nurses, *Students & Allied Medical
(*fax through copy of Student Card)		 R1 200 R1 500
Day Registration R1 200 R1 200
   
Additional Trade Delegates R1 500 R1 500
Accompanying Person: Gala Evening R 350 R 350
     
Total Fees Payable

Payment Instructions
NOTE: If registering as a group, EACH PERSON must complete a separate form. Only full pre-paid registrations will be accepted by the organisers. Bookings are non-transferable.
METHODS OF PAYMENT: Please fax through proof of payment with your name and Registration Form to +27 (0)11 442 8094.
Should this not be received, your booking will be invalid.
Bank deposit or electronic transfer:
Credit Card:
   
Government purchase orders:

All Government purchase orders to be paid by 9 April 2010 and proof of payment to be faxed to +27 (0) 11 442 8094 +27 (0) 11 442 8094 or emailed to clauds.suemc@tiscali.co.za. Your registration will automatically be cancelled if payment is not received by this due date. Confirmation of payment received will be provided in the form of an official receipt. Without proof of payment you will not be receipted and your registration cannot be confirmed.

 

 
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