1. Registration Form (please photocopy form if more than two delegates) (CODE P) Attention:School Conferences Address: P.O. Box 291765 Melville 2109 Fax: 011-482 2543 Tel 011-482 3226 Email: schoolconference@lantic.net Registration, Payment Details and Information: A note will be faxed/emailed to you upon receipt of your registration form, reserving your seat/s Kindly make payment to reconfirm your seat/s Please request for invoice, if required Electronic payment/direct deposit can be made to Standard Bank acct #: 201 096 315. Acct name: School Conferences. Branch: Melville. Branch code: 006105. Kindly indicate school/delegate name as reference Please make cheque payable to: School Conferences An official receipt of your payment will be given to the delegate on conference day No cancellation and refund within seven days prior to the conference date but replacement delegate can be sent No refund if delegate did not show up at conference but documentation pack can be sent Organiser reserves the right to change venue, date, programme and/or speakers if circumstances require. Organiser will refund payment if event is cancelled. If cancellation is not caused by organiser i.e. natural causes, regret no refund will be provided. A discounted fee will be extended to a disadvantaged school if you wish to sponsor a school. Please enquire. If special catering is required i.e. kosher, halal, there will be an additional charge per delegate. Delegate Name:_______________________________ Job Title:_______________________________ Delegate Name:_______________________________ Job Title:_______________________________ School/Organisation:_______________________________ Address:_______________________________ Postal Code:_______________________________ Telephone:_______________________________ Fax:_______________________________ Email:_______________________________ Total Amount Payable: Rand___________________________ Cheque Number:_______________________________ Delegate Name:_______________________________ Job Title:_______________________________ Delegate Name:_______________________________ Job Title:_______________________________ School/Organisation:_______________________________ Address:_______________________________ Postal Code:_______________________________ Telephone:_______________________________ Fax:_______________________________ Email:_______________________________ Total Amount Payable: Rand___________________________ Cheque Number:_______________________________ To enquire and register, contact School Conferences Address: P.O. Box 291765 Melville 2109 Phone: (011)- 482 3226 Fax: (011)– 482 2543 E-mail: schoolconference@lantic.net Delegate Name:Mr/Mrs/Ms__________________ Job Title:_____________________________ Delegate Name:Mr/Mrs/Ms__________________ Job Title:_____________________________ School/Organisation:_____________________________ Postal Address:_____________________________ _________Postal Code ________ Physical Address:_____________________________ __________Area Code ________ Telephone:_____________________________ Fax:_____________________________ Email:_____________________________ Total Amount Payable:R___________________________ Signature: Submitted By: School/ Organisation: Date: CONFERENCE ON HANDLING CRISIS AND TRAUMA IN SCHOOLS Thursday 28 July 2005 FEE R850 per delegate inclusive of lunch, refreshments and documentation pack. VENUE WF Faulds VC Conference and Function Centre at the SA National Museum of Military History 22 Earlswold Way, Johannesburg (Tel: 646 5513) (It is located around the JHB ZOO in Saxonwold)