Registration

PDF Please click here to download the Registration form

PDF Please click here to download the Credit Card Authorization form

Day Registration
  1. All fields marked with (*) are required.

  2. Title(*)
    Please specify your title
  3. First Name(*)
    Please fill in your First Name
  4. Last name/Family name(*)
    Please fill in your Last Name
  5. Tel no
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  6. Cell / Mobile no(*)
    Please fill in your cell number
  7. Profession
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  8. Your Email(*)
    Please fill in your email
  9. HPCSA/Student Number
    Please HPCSA number
  10. Special dietary requirements:
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  11. REGISTRATION FEES - Early Bird

    By 31 Dec 2017 (Fees will increase hereafter)
  12. DAY REGISTRATION

  13. Thursday 5 April 2018

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  14. Friday 6 April 2018

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  15. Saturday 7 April 2018

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  16. SOCIAL FUNCTIONS

  17. CONGRESS DELEGATES
    Wednesday, 4 April 2018
  18. Opening Cocktail Function
    Opening Cocktail Function is included in the registration fee

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  19. Friday, 6 April 2018
  20. Congress Dinner
    Additional cost of R400.00 pp

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  21. PARTNERS & SPOUSES
    Wednesday, 4 April 2018
  22. Opening Cocktail Function

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  23. Friday, 6 April 2018
  24. Congress Dinner

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  25. PAYMENT INSTRUCTIONS
  26. Total
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  27. Payment Type(*)

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  28. -Please use your surname as a reference number when submitting the payment.
    -Please submit proof of registration as student. (If registered for congress as student)

    BANK DETAILS
    Name of Account: APPC2017
    Bank: ABSA
    Account No: 9328332203
    Branch code: 632005

  29. Thank you for choosing the Credit Card payment method

    Once you have completed the registration and clicked on the submit button your amount that you have chosen will be displayed as well as a field where you can enter the amount that you would like to pay.

    Complete the field with your chosen amount and then click on "Pay Now" button. Once you have clicked on the button you will be redirected to Payfast for secure online credit card transactions.

  30. Cancellation of Registration:
    Cancellations received by 31 December 2017 will carry a 50% cancellation fee..
    Cancellations received from 31 December 2017 will carry a 100% cancellation fee.

  31. anti spam(*)
    anti spam
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