Indaba6 Reg form

30 August - 4 September 2009, Berg-en-Dal, Kruger National Park, South Africa

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Registration Form

Title :
Initial(s) :
First Name(s) :
Surname :
Name to be displayed on name tag :
Department :
Organisation :
Postal Address :
Town / City :
Postal/Zip code :
Country :
e-mail :
Telephone (inc. country & area codes) :
Fax (inc. country & area codes) :

Registration :

Full delegate

Full time student

Accommpanying person

Name(s) of accompanying person(s) :

Special dietary requirements :
Other special requirements :

ACCOMMODATION :

Please contact the Workshop Secretariat for a quote should you wish to bring your family to INDABA 6

Preferred type of accomodation :

Type A
(Single)

Type B
(Share with one)

Type C
(Share with two)

Type D
(Share with four)

Type E
(Camping site 1 occupant)

Type E
(Camping site 2 occupants)

I would like to share with :

MEALS :

I would like to book 5 breakfasts (Monday - Friday) for	people
I would like to book 3 dinners (Monday - Wednesday) for	people

PRESENTATION :

Type of presentation :

Oral

Poster

None

Provisional Title :

TRANSPORT :

Bus transport from OR Tambo Int. Airport (Johannesburg) to Berg-en-Dal (and return) for	people
Bus transport from Kruger Mpumalanga Int. Airport (Nelspruit) to Berg-en-Dal (and return) for	people

Please check all your details carefully before clicking the "Send" button.
Clicking "Clear" will clear all the entries on the form.

Please note: Online submission of this form requires access to your e-mail account. If the copy of the browser you are using cannot access your e-mail account, please either print and fax this completed form, or download and complete the text only version and fax (+27 12 807 1699) or email (thereza@technoscene.co.za) it to Thereza Botha.
You should receive confirmation of the recept of your registration form within a few days of its submission. If you do not, please contact Thereza Botha to check its status.