19 - 21 September 2011

Reservation Form

Delegate Information:
Name:
Email Address:
Telephone Number:
Fax Number:
Country of Origin:
Arrival Date in Johannesburg:
Arrival Flight Details: _{If you do not know your flight details at the time of completing this form, please forward the form to us – and let us know your flight details at a later stage}
Arrival Time:	Flight Number:
Transfer to hotel from Airport:	Yes No
Hotel 1^st Choice:
Hotel 2^nd Choice:
Hotel 3^rd Choice:
Occupancy:	Single Double Twin
Departure Date:
Departure Flight Details:
Departure Time:	Flight Number:
Transfer to Airport from hotel:	Yes No
Companion Details (if applicable):
Companion Name:
Arrival Date:
Departure Date:
Pre & Post Conference Tours - Please indicate which tours you are interested in:
Post Conference Technical Tour as per website:
Post Conference One-day Sightseeing/Technical Tour
Tailor Made Tours (Contact Pembury Tours directory) _{kerry@pemburytours.com}
Additional Requests / Comments: