DEPASA CONFERENCE 2019 Registration Form “Doing the Right Thing on a Difficult Day” Date: Venue: Cost:
17 – 18 May 2019 Witwatersrand University Centre for Deaf Studies 1 Jan Smuts Avenue, Braamfontein 2000, Johannesburg R1900 per delegate
Please note that accommodation and transport are NOT included
BANKING DETAILS Name: Bank: Account: Amount:
DEPASA First National Bank 62718308746 R1900
Email Completed Forms to finance@delabatskool.co.za Please email all completed forms with proof of payment to: Adriana Van Zyl (De La Bat School) finance@delabatskool.co.za
Registration Form Please enter your details in the space provided. All fields need to be completed School Details School Name Address Postcode Tel Fax Email
Delegate Details Name and
Position
T-shirt size
Position
T-shirt size
Position
T-shirt size
Position
T-shirt size
Surname Name and Surname Name and Surname Name and Surname
Special Requirements Dietary or special needs. Please indicate your preference Halaal
Kosher
Vegetarian
Meat
Comments:
Please sign and confirm that you have read and accepted the Terms and Conditions
Signature:
Date: