Qualification / Programme
Purchase Order No
Commencement Date
Company Name
Company VAT No
Physical Address
Postal Address
Delegates Surname
Delegates First Name
Delegates Title
Delegates Designation
Period Position held
Delegates Qualification
Delegates ID No
Delegates Tel
Delegates Fax
Delegates Cell
Delegates Email
Division responsible for payment
Contact Person
Is you conpany sponsoring you?
GIMT to provide progress report?
Whom to receive the reports?
Authorised by (Name)
Designation
Food Requirements
Other Food Requirements
Full Name of Delegate
Signature of Delegate
Date
Authorizing Signature (if applicable)
Name of authorized signatory
I acknowledge that by registering for this programme I am personally responsible for the settlement of the programme fees, should my company not pay for any reason whatsoever. I am also aware that for my material to be received timeously, payment is to be received by GIMT two weeks prior to programme commencement.
Cancellation Clause: Delegates who cancel their registrations 14 days prior to commencement will be liable for 50% of the programme fees. Cancellations received 7 days prior to commencement will be liable for 75% of the programme fee. Non-arrivals will be charged the full fee of the programme. All Confirmed registrations will be subject to the above mentioned cancellation clause.
