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40^th Meeting of the Physiology Society of Southern Africa

“Understand, Prevent, Regenerate”

10-13 September 2012

Department of Physiological Sciences, Mike de Vries Building, Stellenbosch University Main Campus, South Africa


Final Programme on website

PSSA 2012 REGISTRATION FORM

Word Document (Registration and Abstract form)

PSSA Announcement (pdf)

Final Programme PSSA 2012 - pdf

Directions to Conference venue, Cocktail party and Conference dinner

Stem Cell Workshop Information

Accomodation for PSSA:

Labri Manor – www.labrimanor.co.za

Just Joey Guest House – www.justjoey.co.za

Ryneveldt Country Lodge – www.ryneveldlodge.co.za

Rusthuiz Guesthouse – www.rusthuiz.co.za

Fynbos Villa Guesthouse – www.fynbosgeusthouze.co.za

Caledon Villa Guest House – www.caledonvilla.co.za

ABSTRACT DEADLINE: 31 MAY 2012

(STUDENTS WHO HAVE NOT YET PROGRESSED TO THE STAGE OF SUBMITTING A COMPLETE ABSTRACT WILL BE ALLOWED TO SUBMIT A SHORT SUMMARY BY 31ST MAY, AND A FULL ABSTRACT BY THE END OF JUNE 2012).

Please complete the form and e-mail back to (gas@sun.ac.za).

To qualify for early registration fees, please submit and payment BEFORE 31^st of May 2012.

Registration Form
Title (Prof/Dr/Mr/Mrs/Ms)
First name(s)
Surname
Postal address (Department/School, University, Street, City)
Postal Code
Country
Email address
Phone number			Area Code
Fax number			Area Code

Registration fees			Early (on/before 31 May 2012)	Late (after 31 May 2012)
PSSA Members (up to date membership) Membership nr:_______________________ Please complete membership form on PSSA website (http://www.physiolsoc.org.za) and pay registration fees to qualify for discount			R 1200.00	R 1500.00
Non-members			R 1500.00	R 1800.00
Students* (full-time students only) (up to date membership) Membership nr:_______________________ Please complete membership form on PSSA website (http://www.physiolsoc.org.za) and pay registration fees to qualify for discount)			R 520.00	R 750.00
Day (maximum of one day only, please select day with X)			R 500.00	R 500.00
Tuesday	Wednesday	Thursday
*Students must fax (021-8083146) or email (gas@sun.ac.za) a copy of your valid student card
The conference fee include conference bag, abstract book, welcome reception, daily refreshments and lunches (Tuesday to Thursday).

Please indicate if you intend to submit an abstract and if you will be entering the competition or the non-competition category

WYNDHAM COMEPTITION

Honours

MSc

PhD

JOHNNY VAN DER WALT POSTER COMPETITION

New Competition (Best Oral presentation for post-doc’s and non-student staff members)

Basic Sciences

Applied Sciences

Non-competition

Oral

Poster

Workshops

Pre-conference workshops

Imaging

LabTutor

Post Conference workshops

Stem cells

SOCIAL FUNCTIONS

Cost

Number attending

Welcome reception – delegate

FREE

Welcome reception – accompanying persons

R 100.00

Conference dinner – delegate

R 250.00

Conference dinner – accompanying persons

R 250.00

Special dietary requirements

(please specify, vegetarian/halaal/kosher/other)

PAYMENT SUMMARY

COST

Welcome reception (for accompanying persons)

Registration fee

Conference dinner (R250 per person)

Total

Method of Payment

Please make payment in South African Rands (ZAR) by cheque, made payable to

“University of Stellenbosch”

Post to: PSSA 2012

Private Bag X1

Matieland

7602

National:

Standard Bank

Account: 073006955

Branch code: 050610

Account name: University Stellenbosch

Cheque account

Reference : R2593 + delegate surname

International:

First National bank (FNB)

Account: 62116972416

Swift code: FIRNAZZJJ

Physical address of bank: 240 Main Road, Newlands, Cape Town, South Africa

Reference : R2593 + delegate surname

Fax or e-mail proof of payment to 021-8083145 / gas@sun.ac.za. Please indicate the name(s) of delegate(s) and accompanying persons with your payment.

(12 Times New Roman, 1.5 Spacing)

TITLE:

AUTHOR(S)

AFFILIATION(S)

ABSTRACT (250 word limit) Word count:_________