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Details of Delegate(s)

1. Full name of delegate:* Email address:* Cell no:
2. Full name of delegate: Email address: Cell no:
3. Full name of delegate: Email address:

   Individual, Organisation & Billing Information

   Kindly insert your VAT number in respect of invoicing:
   Individual / Organisation:*

   Postal Address:
   ID Number:*

   Company registration no:
   Relevant order no:
   Postal code:*

   Tel:*

   Fax:
   Name and surname of person responsible for payment of this account:*
   Email address of person responsible for the payment of this account:*

   Number of person responsible for the payment of this account:*

   Note: VZR must receive payment of the full amount due before a delegate attends the seminar. Should a delegate register for a seminar and not be able to attend, for whatever reason, such cancellation must be in writing and received by VZR at least 15 calendar days before the date of the seminar. If such cancellation conditions are not met, the delegate will be held liable for the full seminar fee.

   I agree to the above.