THREAT 2019 Conference Registration Form
Please note that once this form is submitted you are required to pay the conference fees via eft into the account:
Bank: First National Bank,
Account Name: Cybersecurity Institute Africa (Pty) Ltd,
Account Number: 62793628721,
Branch Code: 255050,
Swift Code: FIRNZAJJ
Payment Reference: SurnameInitial

REGISTRATION FEES

BEFORE THE 30 APRIL 2019

Standard registration: R5500
Academic staff: R5000
Verified Student: R4000

AFTER THE 30 APRIL 2019

Standard registration: R6000
Academic staff: R5500
Verified Student: R4500


PLEASE ENSURE THAT YOU INCLUDE YOUR PAYMENT REFERENCE SO THAT YOUR PAYMENT CAN BE CORRECTLY ALLOCATED. PLEASE ENTERE YOUR PERSONAL EMAIL ADDRESS BELOW.

Email address *
COMPANY DETAILS *
Your answer
Name *
Your answer
Surname *
Your answer
Please select the sector that best represents your participation at this summit. *
Please indicate your nationality *
Please indicate your dietary preference. *
Of the options listed below, please select those that most closely matches your position in your organisation *
Are you a presenter? *
We have collected your email address in this form. We will not use this email address for any other communication, except to contact you in relation to this conference. Should you agree to be contacted by us for any other matter related to future events that we are planning, please indicate so below. We will not share your contact details with anyone. *
YES
NO
Please CONTACT me for future events.
A copy of your responses will be emailed to the address you provided.
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