CRIMSA
Postnet Suite #468
P/Bag X15
MENLOPARK 0102
REGISTRATION FORM: CRIMSA BIENNIAL CONFERENCE 2013
VENUE: SAINT GEORGE HOTEL & CONFERENCE CENTRE,
TUESDAY 17th to FRIDAY 20th September 2013
(Please print clearly using a black ink pen or type in MSWord
E-mail to: aminnaar@unisa.ac.za or sewpes@unisa.ac.za. Alternately fax to: 0866 954 534
(More information and downloadable forms at www.crimsa.ac.za)
TITLE (insert (X) in box)
SURNAME
FIRST NAME
DEPARTMENT/POSITION
UNIVERSITY/ORGANISATION
ADDRESS
POSTAL CODE
TEL NO. (w)
E-MAIL
REGISTRATION FEES
Full registration fee
Ms
Mrs
Mr
Dr
Prof
CITY
COUNTRY
FAX NO.
CRIMSA member fee
R1 800 (Int. US$180
or equivalent)
R1 000 (Int. US$100
or equivalent)
R500/US$50
or equivalent)
Non-member fee (SA & Int.)
R2 000 (Int. US$200
or equivalent)
Student registration fee
R1 300/US$130
(provide proof of registration)
or equivalent)
Daily Registration
R550/US$55
or equivalent)
University where registered:
Student No.
Conference dinner on 19th September 2013 (non-participating
R250/US$25
accompanying partners can attend on additional payment)
SPECIAL DIETARY REQUIREMENTS AND DISABILITIES (X)
Halaal
Vegetarian
Kosher
Other (please state)
Disability (please state)
(X)
(X)
REGISTRATION
FEE:
INCLUDES
CD
WITH
ABSTRACT
BOOKLET/PRESENTERS
POWERPOINT/PAPERS; MORNING & AFTERNOON TEA/COFFEE; LUNCH AND CONFERENCE
DINNER ON 19th SEPTEMBER.
FOR ORGANISATIONAL PLANNING PLEASE INDICATE (X) DATES & FUNCTION OF ATTENDANCE
Tuesday 17th Sept
Thursday 19th Sept
Conference dinner 19th September
Wednesday 18th Sept
World Crime Forum Day
Friday 20th Sept
Conference dinner 19th September- partner
Deposit payment or make an electronic transfer to CRIMSA and email or fax registration form
together with the proof of payment to: E-mail: : aminnaar@unisa.ac.za or sewpes@unisa.ac.za or
Fax: 0866 954 534 (only for local applications).
BANKING DETAILS: Swift code (International transactions): ABSAZAJJCPT
Name of bank:
ABSA Bank (Branch address: 1102 Burnett Street, Hatfield, Pretoria. PO Box
7263, Pretoria, 0001, SOUTH AFRICA)
Account holder name: CRIMSA Branch code: 335-545 Account number: 010471656 (Current
account)
INSERT AS REFERENCE: CRIMSACNF2013(+)SURNAME
*
Please note the following: ACCOMMODATION is for delegates own account. TRANSPORT
between your hotel and the conference venue is not included in the conference fee. (The Saint
George Hotel Conference venue has a limited number of rooms available for delegates – early
booking essential).