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REGISTRATION FORM



Emotional Intelligence for Engineering Success

Please fill in the form, and then press the Submit button to send it to CESA.

* = Not required

Dates & Times

Venue

·Mon 27 November 2017
08:30 to 16:30

·Tue 28 November 2017
08:30 to 16:30

 CESA Training Centre
Johannesburg, Paulshof
Note: The CESA Paulshof venue is a disability friendly zone

Organisation Name & Type:


(Please select a matching company name from the list presented, or type in your company name if no match is found)
Type: 		Purchase order number: *
CESA Account number: * VAT number: *

Postal Address:

City:

Postal code:

Booking made by:    
Your name: Telephone:
Your email: Fax:
       
Who is responsible for payment? Email:

Attendees

To add more attendees, click the "Add Another Attendee" button.

Title:
Prof. Dr. Mr.
Mrs. Ms.  
Designation: (e.g. CEO, Managing Director, Personal Assistant etc)
First Name: Surname:
ID Number / Passport Number:
ECSA registration number: *
SAICE member number: *
Dietary restrictions / allergies:

Telephone:

Mobile:

Fax:

E-mail:

NB! Did you remember to fill-in your / the attendees' dietary restrictions? i.e. Halaal / Kosher / Strictly Halaal / Vegetarian

I have ensured that payment has been authorised for this training, and accept that I will not attend if payment is not received

Please click only ONCE. A confirmation will be sent to your email address.

 

Please note we may occasionally send emails to past attendees advising of new courses. You may opt out of these emails at any time.

Terms and Conditions:
Note: Your booking will only be confirmed upon receipt of a formal/written confirmation from either parties and/or proof of payment thereof.
No refunds will be awarded if delegates cancel within 5 working days / Substitutions of delegates will be allowed.
CESA endeavors to send notice of confirmation/ cancellations and postponements of its training courses at least 5 working days before the course date/s and hence will not be liable for costs incurred for accommodation and transport arrangements made for delegates prior to this period - CESA reserves the right to request related proof in the event that cancellations/ postponements of courses occur within the 5-day period.

For office use only.
Date: _________________Acc No: ________________________ Invoice No: _____________________ Code: __________________