30th March - 2nd April 2010 SANDTON CONVENTION CENTER , JOHANNESBURG , SOUTH AFRICA

all items with * are compulsory

COMPANY NAME : *
NAME : *
SURNAME : *
COUNTRY : *
CHAMBER OF COMMERCE MEMBER
Yes No

 IF YES , REGISTRATION NO.

GOVERMENT EMPLOYEE :
Yes No

 IF YES , DEPARTMENT :

NAME OF CONTACT PERSON :
CONTACT NUMBER :
ADDRESS : *
ZIP / POSTAL CODE : *
TEL NO : *
FAX NO : *
E-MAIL : *
CELL : *
NAMES OF DELEGATES : *
TYPE OF PACKAGES : *
Full Package No. of people :
Plenary Only No. of people :
Workshops Only No. of people :
SELECT WORKSHOP *
NO. OF PEOPLE ATTENDING WORKSHOP *
EXTRAS *
Gala dinner Closing cocktail Spouse day out Golf day
TYPE OF INDUSTRY : *