Registration

PDF Please click here to download the Registration form

PDF Please click here to download the Credit Card Authorization form

Full 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 15th January 2018

    (Fees will increase hereafter)
  12. PRE-CONGRESS WORKSHOPS

    Wednesday, 4 April 2018
  13. Subject to change
    Half day Workshops TBC: 
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  14. FULL CONGRESS

    Wednesday, 4 April – Saturday, 7 April 2018
  15. General Delegate Fee
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  16. Student Fee
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  17. SOCIAL EVENTS

  18. CONGRESS DELEGATES
    Wednesday, 4 April 2018
  19. Cocktail function included in registration fees

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  20. Friday, 6 April 2018
  21. Congress Dinner

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

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  24. Friday, 6 April 2018
  25. Congress Dinner

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  26. EXHIBITORS

  27. Additional trade registration
    2 free trade registrations per stand
    1 free trade registration per table
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  28. PAYMENT INSTRUCTIONS

  29. Registration Total
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  30. Social Total
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  31. Total
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  32. Payment Type(*)

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  33. -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

  34. 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.

  35. Cancellations received by 31 December 2017 will carry a 50% cancellation fee.
    Cancellations received from 31 December 2017 will carry a 100% cancellation fee.

  36. anti-spam(*)
    anti-spam
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  37. You can now submit your registration and continue to the payment page.
  1. Total Paid
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  2. Unpaid
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  3. Date of Payment
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