Conference Registration

Please complete the from. When making payment please put your initial and surname as reference. Email your proof of payment to treasurer@icfgauteng.org or fax to 086 539 3096

VENUE: HELDERFONTEIN ESTATE DATE: 16 SEPTEMBER 2011

PAYMENT INFORMATION:		INVOICE DETAILS:
Account Name:	ICF Gauteng Chapter	Account Contact Person:
Bank:	Nedbank Norwood	Company Name:
Branch code:	191905	Billing Address:
Account number:	1919565760
Account type:	Current Code:	Code:

Title:

Name:

Surname:

Postal Address:

City:

Province:

Postal Code:

Country:

Phone:

Cell Phone:

E-mail:

Website:

Organization / Society:

Dietary Requirements:

None

Halaal

Vegetarian

Kosher

Registration Fee: *

ICF Chapter Member: – R1500

Non ICF Global Member: – R1800

Reference on Payment:

PLEASE ENSURE YOU HAVE READ THE PAYMENT / CANCELLATION POLICY BEFORE SUBMITTING THIS DOCUMENT

The conference Registration Officer will issue an invoice for payment after the registration application has been processed.

Proof of payment can be emailed to treasurer@icfgauteng.org or faxed to 086 539 3096

Having submitted the registration form, the applicant accepts responsibility for full payment of the registration fee, without prejudice.

Cancellation Policy: If written notification is received by fax, email or letter prior to 30 days of the date of the conference, 50% of the conference fee will be returned. If written notification is received by fax, email or letter between 30 days and 14 days of the date of the conference 25% of the conference fee will be returned. If written notification is received by fax, email or letter less than 14 days prior to the date of the conference the prepayment will be forfeited.

NO REFUND CAN BE GIVEN TO PARTICIPANTS WHO DO NOT ATTEND.

Having submitted this application, I acknowledge that I accept the terms and conditions of registration.