Confluences 11 Registration Form

First Name:

Please enter your First Name only

Surname:

Email Address

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Telephone Number:

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

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Institutional affiliation:

Registration type

Full conference International Delegate (USD 190)

Single day International Delegate (USD 100)

Full conference International Student (USD100)

Please note: proof of status is required for all students.

Single day International Student (USD 55)

Please note: proof of status is required for all students.

Full conference Local Delegate (ZAR 550)

Single day Local Delegates (ZAR 300)

Full conference Local Student (ZAR 150)

Please note: proof of status is required for all students. For local students ONLY the cost of a ticket for any performance is R50.

Single day Local Student (ZAR 90)

Please note: proof of status is required for all students. For local students ONLY the cost of a ticket for any performance is R50.

Please make payment using one of the following options:

EFT Payment:

Bank Name: Standard Bank SA Ltd
Bank Branch: Rondebosch, Western Cape
Branch Code: 025009
Account Name: University of Cape Town, No.1 Sundries Account
Account Number: 071503854
Reference: "CTDPS Conf 11 with Applicant’s full name“
Swift code: SBZAZAJJ

CTDPS Snapscan Payment Gateway

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