7th Sulphur and Sulphuric Acid 2019 Conference event registration

Title *

First Name *

Other Initials

Surname/Family Name *

Preferred Name (for use on name badge) *

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

E-mail *

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 *

Contact details of person responsible for payment *

Registration Fees - All prices are inclusive of VAT (Early registration fees - Before 10 December 2018) *

Authors - R5000

SAIMM Members - R9000

Non Members - R9600

Students/Retired Members - R3500

REGISTRATION ONE DAY (Mon 11 March 2019) - R3500

REGISTRATION ONE DAY (Tue 12 March 2019) - R3500

Technical Visit (Wed 13 March 2019) - R500

SOCIAL FUNCTION: (included in the registration fee for all fully registered delegates and students)
Please indicate for catering purposes if you will be attending this function.

Welcome cocktail party (Sunday—10 March 2019)

Conference Dinner (Monday—11 March 2019)

SOCIAL FUNCTION - Payment required for additional guests

Welcome cocktail party - Sun—10 March 2019 (R500 extra guests)

Conference Dinner - Mon—11 March 2019 (R800 extra guests)

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.

Amount

R

Payment Method *

Offline Payment Paygate - Payweb 3

Billing Zipcode*

Credit Card Number*

Expiration Date*