Please Click Below To Download The Registration Form

 

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
Cell / Mobile No*
Please fill in your cell number
Profession*
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Email Address*
Please fill in your email
HPCSA (If Applicable):
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Special dietary requirements:

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PRE-CONGRESS WORKSHOP FEES
Thursday 25 (09h00 - 17h00) & Friday 26 February (09h00 - 13h00)

Thursday 9 July 2020:
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REGISTRATION FEES - Early Registration - Until 01 November 2020

FULL CONGRESS REGISTRATION FEES
Friday 26 February - Sunday 28 February 2021

Medical Doctors (ALLSA Members):
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Medical Doctors (Non ALLSA Members):
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Nurses, Registrars & Fellows, Allied Health Professionals (ALLSA Members):
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Nurses, Registrars & Fellows, Allied Health Professionals (Non ALLSA Members):
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Exhibitors and Sponsors:
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DAY REGISTRATION - Excluding Workshops

Friday 10 July 2020


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Saturday 11 July 2020


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SOCIAL FUNCTIONS: CONGRESS DELEGATES, SPONSORS & EXHIBITORS

Please note that the social functions are complimentary for Full Congress Delegates
Opening Cocktail Function - Friday 10 July*

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ALLSA Congress Dinner (Saturday 11 July 2020):*

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SOCIAL FUNCTIONS: PARTNERS & SPOUSES

Opening Cocktail Function (Friday 26 February 2021):*

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ALLSA Congress Dinner (Saturday 27 February 2021):*

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Title
Please specify your title
Partner Name:
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Partner Surname:
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Special dietary requirements:

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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: ALLSA 2021
Bank: ABSA
Account No: 9353691284
Branch : Clearwater
Branch code: 632005
Account Type: Savings

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 to This email address is being protected from spambots. You need JavaScript enabled to view it..
Any cancellations received by 01 November 2020 will carry a 50% cancellation fee.
Any cancellations received after this date will result in a 100% cancellation fee.

Anti Spam* Anti Spam
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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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Anti-Spam*
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Notes to Organiser
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REGISTRATION FEES - Early Registration - From 1 June 2020