Interactive Registration Form - RCA Conference Organisers

Title (Prof/Dr/Mr/Mrs/Ms)
REGISTRATION FORM
Surname
First Name
Company/Organisation
(to be invoiced)
Position/Designation
Company postal address
(for invoice)
Purchase order number
(if applicable)
Telephone
Mobile
Fax
Email (please print clearly)
Your company’s accounts
contact person
Accounts telephone number
Accounts email address
Are you a full time post
graduate student? Yes No
Student Number & Course
REGISTRATION FEES INCLUDE:
Conference proceedings, name tag, entrance to all sessions, tea & coffee breaks & lunches on 10, 11 & 12 March 2014. No
accommodation and transport to & from the venue is included in the registration fee.
Please tick the option for which you are registering:
Early Bird Registration Register & Pay before/on 29 November 2013 R6 000.00
Full Registration Register & Pay on/after 30 November 2013 R6 500.00
Full Time Post Graduate Student Please submit proof of student registration R1 500.00
ACCOMMODATION
Accommodation has been negotiated at the Orion Safari Lodge from 9 to 12 March 2014. Prices include dinner, bed &
breakfast and the 1% tourism levy. Deadline for accommodation booking and payment with this registration is Friday 20
December 2013. No accommodation bookings will be taken by the secretariat after this date. Accommodation bookings can
be made and paid for directly with the hotel after Friday 20 December 2013.
Single Rate @ R1 218.00 Dinner, Bed & Breakfast per night
Night of 9 March 2014 Night of 10 March 2014 Night of 11 March 2014 Total
R

Sharing Rate @ R879.00 per person/R1 758 per room Dinner, Bed & Breakfast per night
Night of 9 March 2014 Night of 10 March 2014 Night of 11 March 2014 Total
Please indicate the name of the person with
whom you will be sharing.
SOCIAL EVENT
A special braai has been organised on Tuesday 11 March 2014.
If you do not wish to book accommodation but would like to attend the braai you can
book a place for R200.00 per person
I would like to attend the braai dinner on Tuesday
YES NO
Number of Guest Tickets at R200.00pp
R
Date:
Signature:
You can sign this registration form with an electronic signature or by typing your name in the signature field. By submitting
this form (whether signed or not), you acknowledge that you have read, understood and agree to the terms and conditions
listed below.
Please fax this form to the SAICE Conference Office
086 653 7108 or email to register@rca.co.za
An invoice with banking details will be issued on receipt of a completed registration form.
Please note SAICE is not VAT registered.
Terms & Conditions
• The applicant indicates their desire to be registered for this event and therefore accepts full
responsibility for the payment of the registration fees as stipulated in the registration information.
• If you want to register for a limited participation event please check that there are places still
available.
• Registrations are transferable.
• Payment is due on invoicing.
• All payments must be received prior to the start of the event.
• Payment methods accepted for this event: EFT, Cash Deposit or Cheque Payment.
• If your company has agreed to pay for your attendance it remains your responsibility to make sure
that payment is made by your company timeously.
• Cancellation may be made in writing up to 10 days prior to the starting day of the event. 25%
administration fee will be charged. No refund or credit note will be issued if written cancellation is not
received timeously. You will then remain personally liable for payment of the invoice.
• Bank charges for non-South African payments are for the delegate’s account.
SAICE Conference Office, P O Box 72147 Parkview 2122
Tel +27 11 487 3819 Fax 086 653 7108
SUBMIT