Indaba IV

Registration Form

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Title :
First Name(s) :
Surname :
Department :
Organisation :
Postal Address :
Town / City :
Postal/Zip code :
Country :
e-mail :
Telephone :
Fax :
.
I will be accompanied by :

Preferred type of accomodation :

Single

Share with one

Share with two

I would like to share with :

Type of presentation :

Oral

Poster

None

Provisional Title :

TRAVEL DETAILS :

I would like to book bus transport to Skukuza from :

Arrival Airport :

Not Required

Johannesburg

Kruger Mpumalanga

Arrival flight details (if known)
(only needed if bus tranport is booked)

If not yet known, please add these details to your details check-list included with the final confirmation of registration (sent to you after full payment has been received) and return the amended check-list to the Secretariat

Airline :
Flight No.:
Arrival time & date:

I would like to book bus transport from Skukuza to:

Destination :

Not Required

Durban^*

Johannesburg

Kruger Mpumalanga

^*Option available only if there is sufficient demand

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.

Note that this form will funtion correctly only when used within Netscape or MS-IE version 4 or later.

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This page was last updated 01/05/2003.
Site developed by Dave Liles