Individual Registration

Please enter information in the form below to process registration for event 5th Young Professionals Conference 2021. All fields marked with * are required.

Title *

First Name *

Other Initials

Surname/Family Name *

Preferred Name (for use on name badge) *

E-mail address *

Company name *

Designation *

VAT Registration (Compulsory—SA companies)

Order No.

Company Postal Address Line 1 *

Company Postal Address Line 2

Company Postal Address Line 3

Postal Code *

Country *

Tel/Cell *

Fax

Accompanying Persons Name

Are you a member of the SAIMM? *

SAIMM Membership No.

Would you like to become a member of SAIMM? *

Are you a presenting author? *

Do you require an invitation for visa purposes? *

Special requirements

Cancellation and transfer policy:
Delegates unable to attend the event may send a substitute delegate in their place. Please send written details of substitution. Written cancellations must be received more than 10 working days prior to the date of the event and will be liable for 50% of the event fee. Failure to cancel, or cancellation received 10 working days or less prior to the event date, will result in liability for the full event fee.

Person responsible for payment *

Email address of person responsible for payment *

Phone number of person responsible for payment *

I have read and agree to the terms and conditions of our cancellation and payment policy. *

Payment:
Full payment is due on application for registration. Registration will be confirmed ONLY after payment is received. PROOF OF PAYMENT with your invoice number reflected must be sent via fax or e-mail to the Conference Co-ordinator.
Delegates who have not paid will not be permitted to attend the conference.

Registration Fees - All prices are inclusive of VAT *

Author - R4000

SAIMM/SAGA Members - R5500

Non SAIMM/SAGA Members - R6000

Students - R1500

Retired Members - R2500

REGISTRATION ONE DAY (Monday—21 September 2021) - R4500

REGISTRATION ONE DAY (Tuesday—22 September 2021) - R4500

Cocktail function (Monday—21 September 2021) - Payment required for additional guests only R250 each

Payment Information

Amount

Payment Method *

Offline Payment Paygate - Payweb 3

Billing Zipcode*

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Type*

Card Holder Name*

Verification code*