Mindful Living Meeting Registration
Friday 7 February 2020
Melomed Tokai, Conference Room, 5th Floor
Contact: Cath/ Lynne
netoworkmindfulliving@gmail.com
0828250337 (Cath)
0729054676 (Lynne)

R80 EFT/ cash at the door (R40 for Members)
Email address *
Full Name *
Your answer
Phone (if not on record/ changed)
Your answer
Professional Qualification/ Expertise *
Your answer
Professional Registration number (if applicable)
Your answer
Business Name
Your answer
Business/ Practice location *
Your answer
Would you like to book a table to display your products/ services? (Additional R50/ Free for Members)
Do you have a slide to advertise an upcoming workshop/ event/ promotion you are running? (Additional R50/ free for Members)
Bank Details
R80/ (R40 members) EFT

LC Hogan
CAPITEC BANK
Savings Account
Account Number: 1603261700
Branch Code: 470010
Use your name as reference
I have completed my payment by EFT and sent the proof of payment *
Required
Do you have a prize you would like to contribute to the lucky draw?
Your answer
Comments
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