We offer two options to register for the Congress.

1. You may download the application form, fill it in and fax it to us.

  Click here to download the form * tip: right click on the link and say "save target as"

2. or preferably, please fill in our online form below.

 

Title	*	Mr Mrs Ms Dr Prof	Initials	*
Badge name	*		Surname	*
HPCSA Registration Number			SAMA Membership No
Institution/Practice/Company
Postal Address	*
Work Tel. No.	*		Work Fax No.
Cell Number	*		Email	*
If you require a tax invoice, please provide your VAT nr.
Meal requirements	No special requirements   Kosher   Halaal   Vegetarian
Other meal requirements: Please specify
Special requirements: e.g. physically disabled
Other requirements:

 

 

	Early Bird Registration (before 30 June)	Late Registration (after 30 June)
SAMA Members	R 650.00	R 1 000.00
Non-members	R 1 200.00	R 1 600.00
Note: to qualify for early bird registration we need to receive both your registration form and payment by 30 June at the latest.

 

Please select your payment option below:

EFT / Direct Bank Deposits

You may deposit directly into our bank account. The details are:
Bank: Nedbank
Branch: Hatfield
Account name: South African Medical Association
Account number: 1602 237 387
Please fax or post a copy of the deposit slip together with your registration form to + 27 12 481 2095.

Cheque

Please make cheques payable to: South African Medical Association and post, together with a copy of your registration form to:
The Finance Department
Attention: Molly Tlhaku
P O Box 74789
Lynnwood Ridge
0040