Registration Form
Johannesburg
3 March 2005

All fields are required unless marked with a "*". Name, Title and Company will appear on badge as submitted.

Name

 

Title

 

Company/Affiliation

 

Address

 

Address*

 

City

 

State/Province*

 

Zip/Postal Code

 

Country

 

Telephone

 

Facsimile*

 

E-Mail

 



Registration Fee:

 

ACTE Member R 220.00
Non-Member R 400.00
Non-Member Joining R 1 750.00
Complimentary
       ( If registering as a comp, please include "code")

 

Payment:

 
Check
Direct Bank deposit/Electronic Transfer:
Association of Corporate Travel Executives
Standard Bank, Parktown
Bank Code: 00-03-55
Account Code: 200 827 529




(Note: To pay by check, please do not submit this form on-line. Instead use your browser's print feature to print the completed form, make written note that a check has been mailed, and fax it to Fax +27 11 326-1312. You should also print this form if you require a receipt of registration.)



You may submit this form online by Fax +27 11 326-1312 or Mail: Telsaf Datahouse, Room 215 - 5 Conrad Drive, Blairgowrie, Randburg - Johannesburg, South Africa 2194 You may call T: +27-118866964 for questions or more information.


(REFUNDS ONLY GIVEN ONE WEEK PRIOR TO FORUM.)