RAZAK ACCOUNTING CC

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TRAINING WORKSHOP ENROLLMENT FORM

Dear Clients,

Thanks for your interest in our Training Workshop.

Date of Workshop:_____________________________________________

Venue: ______________________________________________________

Name :_______________________________________________________

Company :____________________________________________________

Address :______________________________ Post Code ______________

Telephone :___________________________ Fax:_____________________

E-mail :_______________________________________________________

Number of Deligates: ____________ X R 1140.00 per person = R ___________________ (VAT Incl.)

Payment Method: (Please select and fill in the correct details for the selected Payment Method)

ABankDeposit:
BCreditCard:

Signature :_____________________________________________________

A - BANK PAYMENT / DEPOSIT 

(Please fax this form back with the proof of payment to 011 492 1104)

Account Holder : RAZAK ACCOUNTING CC
Nedbank : Greenside
Account number: 1975056019
Branch Code : 197505

B - CREDIT CARD PAYMENT

Card Type : Visa  / Master Card
                 

Card Holder : ____________________________________________________

Card Number: ____________________________________________________

CVV Number: ____________________________________________________

Expiry Date : _____________________________________________________

Signature : _______________________________________________________