PRACTICE CONSIDERATIONS IN TODAY'S ECONOMY
This is the online registration form for the following event hosted by Impact Learning.

Event Name: PRACTICE CONSIDERATIONS IN TODAY'S ECONOMY (Specific to all Allied and Health professionals)

12 ETHICS POINTS APPROVED!!
Accredited by Impact Learning (Approved accredited service provider - SAMA)


Date: 28 October 2017
Time: 8:00am - 14:30pm (Registration starts at 7:30am)
Venue: Sierra Hotel, Randburg, JHB
CPD: To be confirmed

Please complete the form below to register. Upon submission, you will receive banking details via the email address provided. To secure your seat, please make payment as soon as possible using your name and surname as the payment reference. E-mail proof of payment to admin@impactlearning.co.za

PAYMENT DETAILS:

Acc. Name: Impact Learning
Acc. #: 62490262632
Branch code: 251655
FNB Account: Cheque/ Current
Swift Code: FIRNZAJJ
Reference: Name and Surname

For event enquiries please email us at admin@impactlearning.co.za

PLEASE NOTE THAT CANCELLATIONS MADE LESS THEN 2 WEEKS PRIOR TO THE EVENT ARE NON-REFUNDABLE

Name
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Surname
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E-mail address (NB: where certificate must be sent to)
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Cell phone number
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PROFESSIONAL DETAILS
Profession
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Place of work
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HPCSA number (if applicable)
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REGISTRATION OPTIONS
Meal Option if attending workshop
All meals are pork free
Registration type
Please select which option you will be paying for:
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If you ordered the DVD option - would you like extra questionniares for your colleagues?
If yes, How many questionnaires. Please include the names and e-mail addresses of the people making use of the questionnaires.
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Physical address and area code for delivery of DVD. Please include an additional R250 to your fee if you are outside of South Africa
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Postal address with area code (incase your physical address falls outside of the courier zones) Please include an additional R250 to your fee if you are outside of South Africa
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Feedback information
Where did you hear about this course?
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Invite a friend
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