REGISTRATION

THE SOUTH AFRICAN SOCIETY OF TRAVEL MEDICINE PRESENTS – TRAVEL MEDICINE IN AN AGE OF CHANGE / 2024 CONGRESS – REGISTRATION FORM

16 – 19 OCTOBER 2024 – STIAS, STELLENBOSCH, CAPE TOWN, SOUTH AFRICA

Please complete the Registration Form below (all fields are compulsory) – please note: You will receive an invoice from the SASTM Office with payment details. Prices shown below are inclusive of VAT.

REGISTRATION IS OPEN

SASTM / PATMF Member Doctor: R 6 000. | SASTM / PATMF Member Nurse/Allied Health: R 4 550.

Non-Member Doctor: R 6 600. | Non-Member Nurse/Allied Health: R 5 200.

There will be a surcharge of R 350.00 for Halaal catering.

Regret No Kosher available. (Please contact the SASTM office in this regard)

REGISTER 3 OR MORE DELEGATES FROM THE SAME PRACTICE AND RECEIVE A 10% DISCOUNT

DELEGATE INFORMATION

Are you a SASTM / PATMF Member?:

Title:

Are you a Doctor, Nurse or Allied Health practitioner?:

First Name:

Surname:

Gender:

ID Number:

Profession:

Personal Email Address

Dietary Requirements

Cellphone Number:

Halaal – will be an extra charge of R 350. per delegate

Medical Registration Board: HPCSA / SANC / Allied Health / Pharmacy Council / Other?:

Medical Registration Number:

BILLING INFORMATION

Company / Clinic Name:

Company / Clinic Postal Address:

City:

Province:

Country:

Postal Code / Zip Code:

Work Phone Number:

Practice Number:

VAT Number:

Message

SUBMIT

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