PHASA 36th CONVENTION & AGM REGISTRATION

Riverside Lifestyle Resort, Vanderbijlpark: 18 - 20 November 2013

To reach the PHASA office by 8 November 2013
Mail: PHASA, PO Box 10264, Centurion 0046 South Africa or
E-mail: joan@phasa.co.za or reception@phasa.co.za or Fax: +27 (0)12 667 2049

First name(s) and Surname(s) of registrant(s): **

Name Surname Special Dietary Req. First-time Attendee Joined PHASA in 2013
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Company (if applicable):
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Contact Person: *
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Postal Address:
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E-mail: *
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EVENT PER PERSON NR PERSONS NAMES FOR ID BADGE PURPOSES
(Insert the names)**
TOTAL (Incl. VAT)
Sunday, 17 November 2013
Liquid Lounge (limited space available) Sunset cruise R 70
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Dinner (delegate own expense to be paid to hotel) R 175
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Monday 18 November 2013
Business Session, including lunch, Full Day R 420
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Fun evening R 330
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Tuesday, 19 November 2013
Business Session, including lunch
½ day
R 330
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Krieghoff Shoot (70 entrees only)       To be paid at the shoot
Spitbraai R 110
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Wednesday, 20 November 2013 – AGM’s
Conservation & Empowerment Fund and
PHASA Annual General Meetings
No cost
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No cost
Lunch R 180
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Ladies Lunch & entertainment (13.00 – 16.00) No cost
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No cost
Gala Banquet, Auction & Dance R 375
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TOTAL (INCLUDING VAT)
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Method of payment: Because of charges, we prefer members to pay by EFT if at all possible, instead of Credit Card.

Direct Bank Transfer:

First National Bank (proof of payment attached). Professional Hunters’ Association of South Africa
Account Number: 50416796008 Branch: Centurion, 261550
Reference: Surname and initials

Credit Card:

Name on credit card:
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Expiry Date:
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CVV (last three digits on back of card):
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Cheque:

To be posted to: PHASA, PO Box 10264, Centurion 0046 South Africa

All Business Sessions, AGM and Evening Functions – Please note that all convention activities are for members and invited guests, anyone wanting to attend must register in advance due to hotel and arrangement requirements.
Cancellations – Registration cancellations must be received in writing and are subject to a 10% administration fee, if received on or before 09 November 2013. A full cancellation fee will apply to cancellations received after the 9th November 2013.

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Type what you see in the field, then click submit to complete your registration.