Registration
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PLEASE COMPLETE REGISTRATION FORM AND FORWARD TO :

INTERACTION CONFERENCING
CAPGAN 2003
GRADUATE SCHOOL OF BUSINESS STUDIES
UNIVERSITY OF NATAL
FRANCOIS ROAD
DURBAN
4041

CAPGAN 2003
REGISTRATION FORM
Registration fees for the 6th Commonwealth Congress on Diarrhoea and Malnutrition (CAPGAN 2003)
  Before
15/4/2003		 After
15/4/2003		 Daily Rate ½ Day Amount
Submitted
Foreign delegates (including registration, accommodation and full board) USD 650 USD 725 USD 250 USD 150
Accompanying person (foreign) USD 300 USD 375 USD 100
Single room supplement (foreign) USD 100 USD 120
Total
Registration details
Title Initials
Surname
First name (for badge)
Position and Institute/Organisation
Address
City Postal Code
Country e-mail
Tel (            ) Fax (            )
Specialty Sub-specialty
Accompanying person
Dietary requests:
If sharing a room please list who you would prefer to share with, every effort will be made to try and accommodate your requests, however, this may not be guaranteed. Title, Name, Initials, Surname and please list from which institution:
  1. Please forward this registration form to the following address:

    2. InterAction Conferencing
    CAPGAN 2003
    Graduate School of Business Studies
    University of Natal
    Francois Road
    DURBAN
    Tel: +27 (0)31 260 1584 – Fax: +27 (0)31 260 1606
    E-mail CAPGAN2003@ nu.ac.za

  2. Deadline for reduced registration is:
  3. Please print CLEARLY
  4. Payment method: bank transfers, crossed cheques or credit cards (see details below)
  5. Deadline for abstracts is: 15 March 2003
  6. Please note that accompanying persons who wish to register should complete the appropriate section of the form.
  7. Payment
    8.
    • Cheques payable to : CAPGAN 2003
    • Bank transfers -NB please fax copy of deposit slip to InterAction Conferencing at +27 031 2601606 (on deposit slip under "reference" please PRINT NAME)
    • Bank details:                              Bank: Standard Bank

      Branch: Gale Place

      Branch Code: 04 25 26

      Account name: CAPGAN 2003

      Account number: 051 175 479

      Swift Address: SBZ AZAJJ

    • Credit cards:I will pay the sum by my credit card:

      Mastercard                  VISA

Name of card holder  
Card number                                
Expiry date  
Signature  

  * Would you require transport from Durban airport at 14h00 to The Champagne Resort and return.

        YES              NO

* Would you require transport from Johannesburg airport to The Champagne Resort and return.

         YES             NO

PLEASE TICK WHICH TIME YOU WOULD PREFER DEPARTING JOHANNESBURG AIRPORT TO CONFERENCE VENUE             14H00              16H00

The transportation will return back to Johannesburg and Durban airports on 21 May 2003 at 13h00

Specify flight details Arrival time flight no:
 
Questions or comments to
capgan2009@gmail.com
Last modified: January 21, 2003