Name

I am

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a Representative of a PVE affiliated member (Fee R20-00)
a Private affiliated member (Fee R20-00)
Non-affiliated (Fee R50-00)

Fee payable at the workshop.

I represent (supply name of affiliated school/institution)

My Email address

My Hometown/City is

Paarl
Wellington
Franschhoek
Stellenbosch
Worcester
Pniel
Simondium
Malmesbury
Tulbagh
Bellville
Kraaifontein
Strand
Wemmershoek
Saldanha
Vredenburg
Ceres
Cape Town
Strand
Other

Hometown if you selected Other above

Phone

My dietry requirements are:

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Halaal
Kosher
Vegetarian
No special requirements
Other (Supply details in message field below)

Message