CASA CONFERENCE 5-7 JULY 2005: REGISTRATION FORM

NAME: (include title)
	
INSTITUTION:
	
ADDRESS:
	
E-MAIL:
	
ARE YOU Giving a paper? (please tick one): Yes    No

If yes, please send abstract by 4 April 2005.

Please indicate your accommodation needs and the total amount you will be paying by ticking the items below:

Conference Fee: R500/R200
Foreign currency Transaction (foreign currency cheques only): R100
Optional Excursion: R85
Accommodation on Campus in residence R155 per night including breakfast:

4th July	5th July	6th July	7th July 

TOTAL AMOUNT PAYABLE:

Please provide some form of proof that you are a student/pensioner.

Method of payment (please indicate how you will be paying):

Cheque (Bank drafts are not accepted)
Made out to University of KwaZulu-Natal, please include reference number R855 5205

Credit Card
Please fill out accompanying form.

Bank Deposit/Bank Transfer

Bank Account Name: University of KwaZulu-Natal 
Account Number: 50871932932	Account Type: Current
Bank: First National Bank	Branch Number: 223626
Branch: Durban Corporate	
Reference Number: R855-5205 (this MUST be indicated in the space for 'Reference' under Recipient Details to ensure that the payment is made to the CASA conference account)

Please fax or post your cheque, a copy of your deposit slip or your credit card details, together with your registration form to:

John Hilton or Anne Gosling, University of KwaZulu-Natal, Howard College, Durban, 4041, South Africa. Tel: +27 31 2601308, Fax: +27 31 2602698 
e-mail: hilton@ukzn.ac.za; or gosling@ukzn.ac.za

YOUR TOTAL AMOUNT PAYABLE MUST REACH THE CONFERENCE ORGANISERS BY 4 APRIL 2005 TO ENSURE THAT YOUR PLACE IS BOOKED.