
1. DELEGATE REGISTRATION DETAILS
Title:
Name:
Surname:
Organisation:
Postal Address:
City:
Postal Code:
Province:
Country:
Tel:
Fax:
Cell Number:
Email:
HPCSA Nr:
Society Membership Nr:
Partner Name:
Cell Number:
Are you a speaker at the Congress?
Society
2. REGISTRATION FEES	Early Registration Book and Pay before 1 June	Late Registration Book and Pay after 1 June	Last Minute Registration Book and Pay after 16 July
A. SAGES and SASES Members
SAGES & SASES Full Congress Registration	R 2950.00	R 3550.00	R 4050.00
SAGES & SASES Day Registration on	R 1500.00	R 1750.00	R 2050.00


B. Non-Members
Full Congress Registration	R 3650.00	R 4150.00	R 4650.00
Day Registration on	R 2000.00	R 2300.00	R 2600.00

C. SAGINS Members and REGISTRARS
SAGINS & REGISTRARS Full Congress Registration	R 1350.00	R 1750.00	R 2150.00
SAGINS & REGISTRARS Day Registration on	R 650.00	R 950.00	R 1250.00

D. Other
Trade Full Registration			R 2000.00
WORKSHOPS
Gastro Foundation Research Session - Thurs 29 July 2010 at 9h00			Included
Free papers - Thursday 29 July 2010 at 12h00			Included
Private Practice Session - Thursday 29 July 2010 at 15h00			Included
Workshop only - Friday 30 July 2010			R 2000.00
3. SOCIAL FUNCTIONS
Welcome function			Included
Gala Dinner			R 300.00
Gala Dinner - Partner			R 300.00
4. DIETARY REQUIREMNENTS
Please indicate your dietary requirement:
If Other, please specify:

5. PAYMENT METHODS
The total due is R0.00. How would you like to pay?
Please enter your details and select a registration type