Details of person completing and submitting this form:
Title
*
- - -
Mr.
Ms.
Dr.
Prof.
First name
*
Last name
*
Position
Tel number
*
Cell number
Email address
*
Person / company / organisation to be invoiced:
Your order number / reference
*
Invoice to
*
Department
Postal address
*
Suburb / town
*
Postal code
*
Country
*
VAT number
Delegate details (please submit a separate form for each delegate / presenter / exhibitor staff attending):
Title
*
- - -
Mr.
Ms.
Dr.
Prof.
First name
*
Last name
*
Company / organisation
Position
Tel number
Cell number
*
Email address
*
Registration as a
*
Conference delegate
Conference delegate - 5+ from same organisation (reduced price)
Conference delegate - government (reduced price)
Conference delegate - student (reduced price)
Conference presenter - attending day of presentation only (no cost)
Conference presenter - attending full conference (reduced price)
Exhibitor staff - full hospitality and conference (reduced price)
Exhibitor staff - no hospitality or conference (no cost)
Dietary requirements
Standard
Vegetarian
Halaal
Kosher
Terms and Conditions of Sale: Please see the full SA GeoTech 2019 Terms and Conditions of Sale (above) applicable to this order. Invoices are mailed on receipt of this delegate registration order and booking form. Payment is due within 30 days from the end of the month in which the relevant invoice is dated, or by 30 June 2019 whichever date is sooner. For cancellations received in writing on or before 15 June 2019, the delegate / presenter fee will be waived and/or refunded in full. Thereafter cancellations will not be accepted, although an alternative delegate / presenter nominated by the contracting person / company / organisation is welcome to attend in place of the registered delegate / presenter.
Terms and Conditions of Sale
*
Confirmed and accepted
Authorisation: The person completing and submitting this delegate / presenter registration order and booking form hereby certifies that he/she is duly authorised to place this order on behalf of the contracting person / company / organisation, who will be invoiced accordingly and will be responsible for settling the account as per the SA GeoTech 2019 Terms and Conditions of Sale (above).
Authorisation
*
Confirmed and accepted