Registration - Early Bird until 30 March 2019 

All fields marked with (*) are required.

Title(*)
Please specify your title
First Name(*)
Please fill in your First Name
Surname:(*)
Please fill in your Last Name
HPCSA (If Applicable)
Please HPCSA number
Country:(*)
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Cell / Mobile No(*)
Please fill in your cell number
Profession(*)
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Email Address(*)
Please fill in your email
Special dietary requirements:(*)


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Registration Fees

Pre-Congress Workshop
25 July 2019

Please choose only one relevant option

SATS Radiology workshop: Registrars/Fellow/Nurse/Paramedics
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SATS Radiology workshop: Physicians/Pulmonologist/Radiologists
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CWIG Pectus workshop (full day)
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AFSA workshop: Practical allergy in primary care (full day)
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Full Congress
26-28 July 2019

ALLSA Members
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SATS Members
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CWIG Members
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Non-Members: Specialists / Registrars / Fellows
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Allied Health Professionals / Nurses / Physiotherapists
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Day Registration

*only applicable if you do not wish to attend the full congress
Friday 26 July 2019
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Saturday 27 July 2019
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Sunday 28 July 2019
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Social Events

Congress Dinner
Saturday 27 July 2019

Delegate
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Partners and Spouses
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Payment Instructions

Workshop Total
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Full Congress Total
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Day Registration Total
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Social Function Total
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Full Total
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Payment Type(*)
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- Please use your surname as a reference number when submitting payment
- Please note that all bank charges are to be borne by the delegate.

BANK DETAILS
Name of Account: ASC 2019
Bank: ABSA
Account No: 93 4275 3326
Branch code: 632005
Account Type: Savings
Swift Code: ABSAZAJJ

Thank you for choosing the Credit Card payment method

Once you have completed the registration and clicked on the submit button, the 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 the "Pay Now" button. Once you have clicked on the button you will be redirected to Payfast for secure online credit card transactions.

Cancellation of Registration:
Notice of Cancellation must be given in writing. An administration fee of R500 will be charged to all cancelled registrations received prior to 1 April 2019. Any cancellations received after this date will result in an 100% cancellation fee.

If you have filled in all the required fields, you can submit your registration and continue to the payment page.
   
Total Paid
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Unpaid
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Date of Payment
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