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Contact Information

Name #
Surname #
Professional Status #
Student
Affiliation #
Address #
City #
Country #
Code #
Fax #
Telephone #
Cellphone #
E-mail #
Dietary Requirements i.e. Halaal/Vegetarian #
Accompanying Persons Name
# = required field

Submission preference (please tick off):

       
     

Tentative Title(s) of Abstract(s)


Registration: Workshop (Monday, 7 September 2015) Free for lecturers
  Description

Before
30 April 2015

After
30 April 2015

Students

R600

R600

Regular

R1000

R1000

  Total 1 R

Registration: Conference (8-10 September 2015)
Registration fees include lunch, refreshments, welcoming- and poster sessions:
  Description

Before
30 April 2015

After
30 April 2015

Students  (banquet not included)

R2500

R2500

Regular / Full Participants  (banquet included)

R4500

R5000

Regular / Full Participants  (countries from sub-Saharan Africa)

R3500

R4000

Accompanying Persons  (banquet included)

R2500

R2500

Conference Banquet

R500

R500

  Total 2 R

Conference day delegate registration
  Description Date of Attendance Amount
Students

R900

Regular / Full Participants

R1700

  Total 3   R

Exhibitor registration
  Description

Before
30 April 2015

After
30 April 2015

2 Delegates full conference registration (banquet included)

R20000

R20000

  Total 4 R

Welcoming- & Poster Session / Conference Banquet
  Description

Number of Persons attending

Amount

Welcoming Meet & Greet /Registration Session:
Monday, 7 September 2015, Time: 16:00-18:00, Refreshments will be served

Free of charge

Poster Session:
Tuesday, 8 September 2015, Refreshments will be served

Free of charge

*Conference Banquet:
Wednesday, 9 September 2015, Time: 19:00

R500

  Total 5 R
*Fees are included for regular participants and accompanyings persons, extra tickets for spouses is R500 per person.


Method of Payment

GRAND TOTAL (1-5) R
I will pay by credit card (Master or Visa)
Please complete credit card authorization form and e-mail it to aef2@sun.ac.za  
I have remitted the total amount from my bank
Bank transfer detail: 
Account name: The Macromolecular Society of SA (MSSA)
Address of bank: ABSA, Plein Street, Stellenbosch 7600 South Africa
Account number: 4-1019-0621
Bank/Sorting Code: 632005
Swift Code: ABSAZAJJ
Please fax deposit slip to:  +27(21) 808-4967
 

Cancellation Policy
Registrations cancelled more than 60 days before the event will be refunded 80%, less than 60 but more than 30 days before the event will be refunded 50%, less than 30 days before the event will not be eligible for a refund..

Additional Information

Please send me an invitation letter

Flight / Accommodation Detail

 
Arrival Departure
Arrival Date Departure Date
Arrival Flight Number & Time Departure Flight Number & Time
Name of Accommodation
For further information contact Aneli Fourie: Conference Secretary
Tel: +27(21)808-3174;  Fax: +27(21) 808-4967;  Email: aef2@sun.ac.za