FIRE ECOLOGY CONFERENCE – KRUGER NATIONAL PARK

23, 24, 25 and 26 OCTOBER 2016

REGISTRATION AND ACCOMMODATION FORM

Please complete or indicate with ‘X’ wherever applicable and return to:

Mpumalanga Promotion Events: Tel 082447 1570 or E-mail:

TITLE: Prof/Dr/Mr/Mrs/Miss

/ / FIRST NAME:
(For Name Tag) /

SURNAME:

/

ORGANISATION:

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TELEPHONE

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Code ( )

/

Fax ( )

/

Cell:

E-MAIL

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DIETARY REQUIREMENTS

/

Vegetarian:

/

Other:

/ /

No

/

Other (please specify)

Invoice Details: Address and Vat number (PLEASE COMPLETE THIS PART IF YOU REQUIRE A TAX INVOICE)

Any queries regarding accommodation must be directed to Mpumalanga Promotions

Tel: 082 447 1570, Fax: 086 6130 360 or email

Delegates Registration Fee

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FEE

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TOTAL

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Delegate fee includes;

Conference registration fee, teas, lunches, dinner on 24 Oct

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R1150.00

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Transport and packed lunch for field trip on 25 Oct

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R410.00

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Transport and packed lunch for field trip on 26 Oct

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R410.00

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Sub Total

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Accommodation:

Please tick the nights required

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Cost

per night

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23 Oct

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24 Oct

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25 Oct

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26 Oct

1. 2 Bed Bungalow - single

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R1220.00

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2. 2 Bed Bungalow - sharing

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R610.00

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3. 2 Bed Safari Tent – single

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R550.00

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4. 2 Bed Safari Tent - sharing

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R275.00

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Provide name of person you want to share with:

/ / / / / /
/

TOTAL

PAYMENT

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PAYMENT TO BE MADE TO:

Mpumalanga Promotions Events, ABSA, Nelspruit Branch,
Account number: 4065173200 Branch Code: 632005.
Swift Code ABSAZAJJ / ABSA Nelspruit, 20 Paul Kruger Street, Nelspruit
Please use your surname/fireecology meeting as your payment reference
e.g. smith/fireecology
Please send your booking form and deposit slip / proof of payment to Jackey Deacon at
fax number 086 6130 360 or e-mail to
·  Payment due in full before 1 August 2016