ALLSA

Symposia 2024 Registrar
Educational Donation Form

Congratulations on being selected as a educational sponsored attendee at the ALLSA Symposia on the 15th and 16th of November 2024 in Cape Town to the value of R7000.00.

This educational donation must be used to cover your flights, accommodation and other travel expenses to attend the symposia. By completing the form you confirm that you will attend the symposia and should you not attend the symposia for any reason you will be liable to pay back the donation to ALLSA.

  • BENEFICIARY INFORMATION

  • Hidden

    Delegates Registration

  • Please note that all fields marked with and asterisk (*) is mandatory
  • (e.g. General Practitioner)
  • YOUR BANKING INFORMATION


    Please note we can not make payments to credit card accounts or bank accounts outside of South Africa.
  • Max. file size: 128 MB.
    Please note we can not make payments to credit card accounts or bank accounts outside of South Africa.
  • Mandatory fields are marked with a asterisk (*)