It’s a Date! Windhoek, Namibia – 18 January 2017

info@samra.co.za Ads and Sponsorships, News, Research Suppliers, Research Users/Clients 06/12/2016

SAMRA Event Booking Form

Number of Delegates *

Delegate Details Submission

Please submit the delegate details by downloading and completing the spreadsheet provided just above this booking form and emailing it as an attachment to events@samra.co.za

Please provide details of the contact person for this booking

Booking Contact Person Title, Name & Surname *

For example: Ms Leonie Vorster

Current Position *

Employer Organisation *

Phone Nr (Work) *

Email Address *

Mobile Nr *

The contact person for billing is *

Entity to be Billed *

Please specify if the invoice should be made out to an individual or an organisation, and supply the name of the individual or the organisation. For example: Organisation: SAMRA OR Individual: Leonie Vorster

Billing Address *

For example: PO Box 1713, Randburg, 2125, South Africa

Billing Contact Person Title, Name & Surname *

For example: Ms Leonie Vorster

Billing Contact Person\'s Email *

Billing Contact Person\'s Phone Nr (Work) *

Order Nr (if required) *

VAT Nr (if applicable) *

Any other comments / requests / questions to the organisers? *

I hereby certify that I understand and agree to the following terms and conditions *

Pricing is as follows: R500 ex VAT per person.

I am authorised to transact with SAMRA for this firm booking.

Bookings are firm, unless cancelled within 7 days of making the booking or before the closing date for bookings, whichever is the EARLIER date of the two.

Bookings are on a first-come, first-served basis. Substitutions will be accepted until 11 January 2017.

Bookings close on 21 December 2016.

SAMRA reserves the right, at its sole discretion, to require a deposit, which may be full payment, within 7 days of submitting a booking form.

SAMRA is a registered VAT payer (VAT Nr: 4830124451) and VAT at 14% will apply to all invoices and payments where relevant.

Photographs taken at SAMRA events may be used by SAMRA without permission from the person/s in the photograph.

SAMRA reserves the right to alter or cancel, without prior notice, any of the arrangements relating directly or indirectly to this event, for any circumstances beyond SAMRA’s reasonable control. SAMRA will not accept liability for any losses and/or damages delegates may suffer on account of any alteration or cancellation.

It’s a Date! Windhoek, Namibia – 18 January 2017

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