AFROX REHABILITATION by olliegoblue33

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									                              SASCA
             Overview on Botox and FES Workshop
      JURIE WESSELS SEMINAR ROOM, PASTEUR HOSPITAL
                     24 November 2006
Name: ________________________           Surname: _____________________________
Title: _________________________         Position: _____________________________
E-mail address:___________________________________________________________
Phone No.:    ____________________       Fax No.: ______________________________
Company Name: __________________________________________________________
Address:_________________________________________________________________
      ___________________________________________________________________
      ____________________________ Postal Code ___________________________
Registration Deadline: 17 November 2006
    Would you like the course to be presented in Afrikaans/English (underline your
                                     preference)
       Special meal requirements:
       Kosher        Vegetarian        Halaal               Normal 
_________________________________________________________________
TO REGISTER
Participants are encouraged to register early as place is limited. Please confirm your
place telephonically with Corina Botha at 051 – 5201234 there are limited places.
Please complete the attached registration form and fax with proof of payment to
Corina Botha on (051) 5201231 (e-mail: corina.botha@lifehealthcare.co.za) Payment
can only be made by direct deposit into the SASCA account. Registration will only be
confirmed once proof of payment is received.
Please write your name as a reference on the deposit slip.
Bank:                Standard Bank
Acc Name:            SASCA
Branch Code:         01-26-45-40
Acc Number:          012 257 036
Cost:                R290.00

								
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