NLA Short Course Booking Form

Fields marked Required must be filled in before you can submit this form. Please complete as many fields as possible to facilitate administration.
It is essential that a separate registration form is completed for each attendee.

Personal Details

Surname/Last Name

Required

First Names

Required

Title

Identity or Passport Number

Required

Highest Qualification

Job Title

Company Details — please complete in full for invoicing purposes

Company/Organisation

Required

Company VAT Registration Number

Order Number

Postal Address

Required

Postal Code

Invoicing Address (if different)

Telephone Number

Required (Area Code) & Number

Fax Number

(Area Code) & Number

Cell Number

Email Address

Required

Confirm Email Address

Required

Dietary Requirements

Required

Are you an NLA Member?

YES NO Required

Would you like a quote or an invoice?

Quote Invoice Required

Select the course you wish to register for

Payment

A reference number will be sent to your email address when this form is submitted. Please use this reference number when making a payment. An invoice will be emailed to you after processing of the registration by the NLA. Payment must be received in full to confirm this registration. No refunds will apply for non-attendance; No exceptions will be made.

Accounts Contact Person

Required

Accounts Email Address

Required

BANK DETAILS:
NATIONAL LABORATORY ASSOCIATION
FIRST NATIONAL BANK, LYNNWOOD, PRETORIA
ACC. 54600033549 (Current Account)
Email deposit slip to accounts@nla.org.za

Cancellations

A 30% CANCELLATION FEE WILL BE CHARGED FOR CANCELLATIONS MADE CLOSE TO THE COURSE DATE OR NO SHOWS AT COMMENCEMENT OF COURSE.

Thank you for taking the time to register!