Click here to DOWNLOAD the WORD Registration Form. Go to FILE and select SAVE AS to save the form that
opens. You can then print it OR open it after you have saved it. You can complete the form electronically and
print it and then FAX it OR email it to us.
All registration forms to be with Ndileka Jacobs on or before Friday, 20 July 2012
[We prefer that you fax or email your registration forms. One Registration Form per person only]
You can registrate for the conference in the following ways:
*Option 1: Save this application form. You will be able to complete this form by completing the fields on your
computer. Fax or Email it to Ndileka after you have completed the form. Please follow up with Ndileka to
check whether she has received your fax:
Ndileka Jacobs
Centre for Research, Technology and Innovation
Nelson Mandela Metropolitan University
P O Box 77000
SUMMERSTRAND
6031
You can follow up whether she has received your registration form by contacting Ndileka on:
+27 (0) 41 504 4625 (Tel)
0711 5050 21 (Cell)
+27 (0) 41 504 1076 (Fax)
or email her at ndileka.jacobs@nmmu.ac.za
Ensure that you have indicated the payment option on the form.
If you make payment via depositing into the account OR by making a transfer into the account, please fax or email a proof of
payment to Ndileka Jacobs: 041 504 1076 (Fax) ndileka.jacobs@nmmu.ac.za
Equally important, fax through the Names & Surnames of those who will be attending, as well as the school/organisation's
name who they will represent.
Please follow up with Ndileka whether she has received it.
If you make payment via cheque, please mail the cheque. Please indicate the names of the people who this cheque is for
also on a piece of paper.
*Option 2: Print this application form and complete it in ink. Mail it after you completed it to:
Ndileka Jacobs
Centre for Research, Technology and Innovation
Nelson Mandela Metropolitan University
P O Box 77000
SUMMERSTRAND
6031
You can follow up whether she has received your registration form by contacting Ndileka on:
+27 (0) 41 504 4625 (Tel)
0711 5050 21 (Cell)
+27 (0) 41 504 1076 (Fax)
or email her at ndileka.jacobs@nmmu.ac.za
Ensure that you have indicated the payment option on the form.
If you make payment via depositing into the account OR by making a transfer into the account, please fax or email a proof of
payment to Ndileka Jacobs: 041 504 1076 (Fax) ndileka.jacobs@nmmu.ac.za
Equally important, fax through the Names & Surnames of those who will be attending, as well as the school/organisation's
name who they will represent.
Please follow up with Ndileka whether she has received it.
If you make payment via cheque, please include the cheque with the application form(s). Please indicate the names of the
people who this cheque is for also on a piece of paper.