Psychological Society of South Africa

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14TH SOUTH AFRICAN PSYCHOLOGY CONGRESS

26-29 AUGUST 2008

EMPERORS PALACE, JOHANNESBURG

REGISTRATION FORM
To be completed by all participants (Including presenters, media, guests and trade delegates)

1ST CALL FOR ABSTRACTS (20 CEU)

OPTION:

We offer two options to register for the Congress.

1. You may download the application form, fill it in and fax it to us.

Click here to download the form * tip: right click on the link and say "save target as"

2. or preferrably, please fill in our online form below.

STEP 1 : Personal Details

Title		Initials
Name		Surname
HPCSA Registration Number		PsySSA Membership Number
Institution
Postal Address
Work No.		Work Fax No.
Home No.		Home Fax No.
Cell Number		Email
Fields of Interest

Bank and administration charges incurred (e.g. returned cheque, card authorization refusal) are for the participant's account. A fully completed and signed registration form guarantees registration, confirms participant's attendance and acceptance of registration conditions. Only the above-mentioned methods of payment will be accepted. Written applications for cancellation received before 1 March 2008 will be entitled to a 50% refund; thereafter no refunds shall be made. All conference venues will be on a first come first serve bases. Kindly attend alternate sessions if a venue is fully occupied.

STEP 2 : Select Fees

Registration Fees	Late / On Site		None
PsySSA Member		R2200
Non Member applying for membership		R2500
Non Member		R4300
One Day Fee		R2200
Student Member		R1100
Intern Member		R1350
Student Member applying for membership		R1350
Intern Applying for membership		R2100
Foreign Member *		$500
Foreign Fee		$600

STEP 3 : Payment Details

Please select your payment option below:

EFT / Direct Bank Deposits

You may deposit directly into our bank account. The details are:

Bank: ABSA Rosebank
Branch Code: 630-805
Account: Current Account No. 40-4940-7045

Please fax or post a copy of the deposit slip together with your registration form (address above, fax number + 27-11-486 3266/77).

Cheque

Please make cheques payable to PsySSA and post together with your registration form to:

PsySSA Membership Management,
P.O.Box 989
Houghton
2041

Credit Card

If paying by credit card, please fill in the information below: Credit Card

Credit Card:
Credit Card Number:
Expiry:
Cvv:

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