SALGA National Conference

Surname Gender Male Female
Name Designation
Province Municipality
Phone Fax
Cell E-mail
Dietry Requirements Halaal Vegetarian
Type of disability
for allergies
(if any)		 Yes
(specify)		 No

Payment

Contact person for payments
Name Tel
Cash Deposit Transfer EFT Cheque

RSVP

Due Date 19 August 2011 Tel 012 369 8000
Fax 0866176921 E-mail nationalconference@salga.org.za
Contact Person Charles Tlhoaele (082 887 3108) / Telly Chauke (071 8822 783)