Introduction to Lean Workshop Registration Form
Workshop location: ______________________ Workshop date:____________________
Organisation name:
Organisation contact person:
Telephone (w):
E-mail address
VAT registration No
Postal address:
Title:
First Name:
Job title:
Title:
Cell number:
Title:
Job title:
Dietary Requirement:
Email address:
First Name:
Surname:
Cell number:
Dietary Requirement:
Email address:
First Name:
Job title:
Title:
Surname:
Cell number:
Job title:
Dietary Requirement:
Email address:
First Name:
Job title:
Title:
Surname:
Surname:
Cell number:
Dietary Requirement:
Email address:
First Name:
Surname:
Cell number:
Dietary Requirement:
Email address:
ITL Workshop Fee: R5 450 per person (excl. VAT)
No of participants ...... @ R5 450.00 ea (excl. VAT)
Total Fee:
PO Number …………………………………………….
R
Signature of person authorised to approve
expenditure and accept terms and conditions below:
The discount for registration for both workshops will be
applied upon receipt of both registration forms
LIA bank details: Standard Bank Thibault Square Branch: 020909 Account: 070 488 657
Please take note of terms & conditions: Submission of a registration form shall be deemed to be acceptance of the organiser’s
terms and conditions, as outlined below, and shall be jointly and severally binding on the applicant and the applicant’s corporate
entity. The workshop is contingent on a minimum number of registered participants signing up for the workshop. If the minimum
number of participants is not reached, Lean Institute Africa reserves the right to cancel or postpone the workshop and will notify
registered participants of any changes. Workshop registration fees will be refunded to participants if the event is cancelled and they
cannot attend an alternative workshop date. Please be advised that if you are making travel arrangements to attend the workshop,
Lean Institute Africa cannot be held responsible for any associated travel or accommodation expenses, or associated cancellation
fees resulting from a cancelled workshop. In the event of participant cancellation, 50% of fees will be credited, provided cancellation
in writing is received at least 5 working days prior to the event. After that date, no credits or refunds will be made.
PLEASE COMPLETE AND RETURN THIS FORM TO THE LEAN INSTITUTE AFRICA
(NB: Please contact the LIA office if you do not receive registration confirmation within 2 working days)
Attention: Chantélle Telephone: 27 21 406 1226  Email: leaninfo@gsb.uct.ac.za
Please assist us with our marketing, by telling us how you heard about the workshop: Email
Facebook
Twitter
LinkedIn
Colleague
Friend
GSB
Norman Faull
Anton Grutter Google
 LIA website
Other
If other, please indicate here: ___________________________________________