Event registration
SERIES OF PRACTICAL WORKSHOPS IN MEDICO – LEGAL PRACTICE
February to November 2020
Important Information
Registrations open on Wednesday 18th December 2019.

All participants must be a SAMLA member in good standing.

Once we have received your completed registration forms, we will forward you an invoice. The invoice will contain the bank details and a payment reference number which you must use when effecting payment.

Certificates and CPD letters will be issued in the name of the participant as supplied on the application form.

Practitioners registered with HPCSA will earn CPD points for each workshop attended. CPD letters indicating the awarded points will be issued by UCT. (SAMLA has no influence on the number of CPD points awarded by the HPCSA).

In addition SAMLA will issue medico-legal CPD points for all registered medico-legal practitioners

Participants who attend both (or all 3) lecture days of a workshop, attend and participate meaningfully in syndicate meetings, and complete a satisfactory assignment report, will receive a UCT Certificate of Successful Completion of the training workshop.

Participants who successfully complete the 2018 Foundations Course (whether live or online), and all Workshops 1-10 in 2019 & 2020 will earn a Certificate of Competence in Medico-legal Practice.

Successful completion of all 10 workshops will have the following two important benefits:
o CPD Points both HPCSA & SAMLA Medico-Legal CPD
o Eligibility of higher levels of registration for SAMLA Register of Medico-Legal Practitioners
Details to be determined by the SAMLA Board

Title (eg. Mr/Mrs/Ms/Dr/Adv) *
First Name (Preferred Name) *
Surname *
Name for Certificate *
Email *
SA ID Number *
Date of birth: *
MM
/
DD
/
YYYY
Gender *
UCT student number (if applicable):
Occupation: *
Company
Name of applicable professional registration authority: (eg. HPCSA)
Your professional registration number with applicable authority:
Postal Address *
Work Telephone Number
Cellphone Number *
Which Workshops will you Attend *
Required
Location of Attendance - Should venues be an option again *
Dietary restrictions *
Payment Option *
Please note all payments are due two weeks prior to date of the First Workshop you will be attending. Please ensure that your SAMLA membership is up to date. All Participants must be a SAMLA member in good standing.
Who will be paying for you to attend this invoice
Clear selection
Invoice details
Please note: Individuals and companies will be emailed a statement and payment details on registration.
Please do not complete this section if you are paying as an individual.
Please ensure that you complete this information as it should appear on the invoice.
Invoices will be emailed to the contact person indicated below. Please ensure that you give the correct person’s details.
Note that the attendee’s participant number must be used as reference for the payment. This participant number will appear on your invoice. Do not make payment until you have received the invoice.
Once payment has been made, proof of payment must be sent to admin@samla.co.za.
If payment is unlikely to reach us before the start of the course, we require a letter from your company stating their intention to pay the fee on receipt of an invoice.
Name of Company (only applicable if being paid for by Employer/Company)
Postal Address
Physical Address
Vat Reg Number
Purchase Order Number
Contact Person for Invoice
Email address for Invoice
Telephone number for payment follow up
Would you like to join the UCT Law @ Work Mailing List? *
Terms & Conditions
We will acknowledge receipt of your registration form. If there are no available spaces, you will receive notice of this and your name will go on a waiting list.

Only EFT payments or bank deposits will be accepted.

SAMLA reserves the right to cancel the workshops if insufficient registrations are received, in which case the workshop fees will be refunded in full.

Once we have issued a participant number to a participant, cancellations cannot be refunded. (Participant numbers are assigned once registration is completed.)

By submitting this registration form I become liable for all fees payable for the workshops I have registered for.

By submitting your registration for the SAMLA Workshops, you expressly give SAMLA, Azlyn Creative and UCT Law@Work permission to use your information for the purpose for which it is intended.

This includes but is not limited to sharing your contact information with the above organisations and other participants as required by the syndicates in which you will be required to complete course work and others as required from time to time. You will receive email from the SAMLA Faculty and be added onto the Forum for the Workshops and syndicates.

All the 2020 workshops are video recorded for future use. In terms of the POPI Act participants who engage at the workshops give permission to SAMLA to use these videos in future where those participants are recorded speaking.
I accept the above terms and conditions *
Required
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