Textiles For
Sustainable
Development

 Conference 2005

 23-27 October 2005

The 2005 ESCORENA International Conference

Registration Form

 Please do not exceed field lengths
Title * First Name
 Mr  Mrs  Ms  Dr  Prof
*
Surname
*
 
Organization Designation
* *
 
Postal Address  
*
*
*
 
Contact Details  
Tel. : *
Fax.:
e-mail : *
Mobile : 
Other :
Special Dietary Requirements

 Participating in the study tour?

      Study Tour

   Number of guests

Conference Fees *
    Up to Oct '05
      R3000.00
   
The registration fee for delegates includes all conference activities. Online currency converter.
Please note: No Refunds payable as of 1 September 2005.
 
Method of Payment *
 Bank Transfer
 Cheque
Please fax proof of payment to +27 41 583-2325 for the attention of Mary-Anne Sullivan. Alternatively email the proof of payment to msulliv@csir.co.za.
 
Payment Details  
Account name CSIR
Bank name ABSA Bank
Branch name Lynnwood
Bank Address 230 Van Der Walt Street, Pretoria, 0002
Branch Code 33 47 45 10
Account type Current Account
Account number 54 000 2258
Swift Code ABSA ZA JJ CPT (foreign payments)
Reference HX939 <Insert Your Company Name>
 
Please confirm registration by : * e-Mail (Preferred)  Snail Mail  Fax
 
  * - Indicates a required field