Co-operative
Education

Event Management System

Event Management System
Registration Form
Title  Prof
 Dr
 Mr
 Mrs
 Ms
 Miss
 Other (please specify)
Name
Surname
Address line 1
Address line 2
City
Country
University/Institution
Staff number (DUT Staff only)
Faculty
Department
Mobile number
Work number
Email address
Registration fees  Standard registration R5000.00
 Early bird registration R4500.00
 DUT staff R3000
Pre-conference workshops  Workshop Full day R1000.00
 Workshop Half day R600.00
Gala Dinner (Delegate) R500.00  Yes
Gala Dinner (Partner) R500.00  Yes
Welcome Cocktail R0  Yes
Dietary preference  None
 Vegetarian
 Halaal
 Kosher
 Vegan
 Other, please specify
Please specify if other
Book of abstracts  Require a hard copy
 Will access e-copy
Do you require transport from airport to accommodation  Yes
 No
Do you require transport from accommodation to airport  Yes
 No
Do you require transport to and from your accommodation and the conference venue  Yes
 No
Do you require transport to and from the gala dinner  Yes
 No
I consent to my details (name, institution and email address) being included in a Conference delegate list in the Book of Abstracts  Yes
I do not consent to my details being included in a Conference delegate list in the Book of Abstracts  Yes
© Copy Rights Mamashela Consulting cc

HELTASA CONFERENCE 2017
21-24 November 2017
Durban, South Africa
HIGHER EDUCATION WELL-BEING: Transcending Boundaries, Reframing Excellence

All information should be typed out in full (e.g. Durban University of Technology).
All information should be typed in upper and lower case (e.g. Thuli Zulu).

An email confirming your registration will be sent to you with the invoice for payment.
If you do not receive a confirmation e-mail within 10 days, please contact the Conference organiser via email at heltasa2017@dut.ac.za

 

The above shuttle will be available from the airport and accommodation within the Umhlanga region