NOT LOGGED IN
 

R E G I S T R A T I O N   F O R M DMISA CONFERENCE ATKV GOUDINI SPA: 8 AND 9 OCTOBER 2008 ANNUAL GENERAL MEETING: 10 OCTOBER 2008 ONE FORM PER DELEGATE: DUPLICATE AS REQUIRED   REGISTRATION FEES MEMBERS OF DMISA:         R2 900-00 NON-MEMBERS:                  R3 300-00 PLEASE NOTE THAT THE INSTITUTE IS NOT REGISTERED FOR VAT

IMPORTANT INFORMATION A              REGISTRATIONS MUST BE LODGED BY 1 SEPTEMBER 2008. LATE REGISTRATIONS WILL BE SUBJECT TO A PENALTY OF R300 PER DELEGATE. LATE REGISTRATIONS WILL NOT, IF ACCEPTED, AUTOMATICALLY QUALIFY THE DELEGATE FOR CONFERENCE BAGS/HOLDERS, PAPERS, SPECIAL FUNCTIONS ETC. B              NO REGISTRATION WILL BE ACCEPTED UNLESS ACCOMPANIED BY THE REQUIRED PAYMENT OR PROOF OF PAYMENTS HAVING BEEN MADE DIRECTLY INTO THE INSTITUTE�S ACCOUNT. C.             CANCELLATION OF REGISTRATION WILL BE ACCEPTED before or until 1 October 2008 � SUBJECT TO A CANCELLATION FEE OF R300.

REGISTRATION DETAILS   1.       FULL NAME AND SURNAME:          ______________________________________________________             ___________________________________________________________________________________   2.       MEMBERSHIP NUMBER: ________________________     TITLE: __________________________   3.       NAME OF COUNCIL OR INSTITUTION YOU REPRESENT:             ___________________________________________________________________________________   4.       HOW SHOULD YOUR NAME BE REFLECTED ON THE NAME TAG:             ___________________________________________________________________________________   5.       TEL (Code): _____ NO: _________________ FAX (Code): _____ NO: ____________________   6.       CELLULAR NO: _________________________ E-MAIL: _________________________________ 7.       WILL YOU BE ATTENDING THE FUNCTION ON THE EVENING OF 7 October 2008?                          (Meet and greet)                     YES / NO     :         _________________________ 8.       WILL YOU BE ATTENDING THE FUNCTION ON THE EVENING OF 8 October 2008?           (Mayoral function)                           YES / NO       :         _________________________ 9.       WILL YOU BE ATTENDING THE FUNCTION ON THE EVENING OF 9 OCTOBER 2008?           (Members attending AGM)               YES / NO       :         _________________________   10.      WHERE WILL YOU BE STAYING : ____________________________________________________ 11.      SPECIAL Food preferences (please indicate) :           *   Halaal           * Kosher     * Vegetarian

Members: WILL YOU BE ATTENDING THE AGM ON 10 OCTOBER 2008?   (See 9 above) YES / NO : ____________

REGISTRATION FEES CAN BE DEPOSITED DIRECTLY INTO THE DMISA ACCOUNT. IF THIS IS DONE, PLEASE FAX PROOF OF DEPOSIT, TOGETHER WITH THE REGISTRATION FORM TO: 086 652 8066 or e-mail: [email protected] ACCOUNT DETAILS ARE:                     ACCOUNT NAME: DMISA          BANK: ABSA                                                                 ACCOUNT NUMBER: 650 154 290 (EDENVALE) IF REGISTRATION AND FEES ARE TO BE POSTED � PLEASE POST TO : DMISA CONFERENCE 2008                                                                                                                    P O BOX 7130, PRIMROSE HILL, 1417 PLEASE INSERT YOUR NAME AND SURNAME ON THE RIGHT BOTTOM OF THE DEPOSIT SLIP IN THE REFERENCE COLUMN!!

NAME OF OFFICIAL WHO HAS COMPLETED THIS FORM: __________________________________________________   TEL: (          )_______________________    FAX: (          )_______________________ E-mail: ______________________