DEBT COUNSELLOR TRAINING COURSE (2014) Thank you for enrolling for the Institute of Bankers in South Africa (IOBSA) Debt Counseling course. Please fill in this form to confirm your enrolment and fax it to: 0865 220 991. Course attendance information Date of attendance: Title: Name: Surname: ID number Non member Member: Membership no: Company: Position: Special dietary requirements: Vegetarian Halaal Kosher Other Contact details Telephone Work: Mobile: Home: E-mail Postal address Payment details Account name: The Institute of Bankers in SA FNB current account: 5060 6050 909 Branch code: 251 705 Documentation required with this registration: Copy of ID / Passport Proof of payment Should you require any additional assistance please contact the IOBSA office The Institute of Bankers in South Africa Reg. No: 2002/011503/08 2nd Floor, Sandown Mews West, 88 Stella Street, Sandton, 2146. PO Box 781988, Sandown, 2196, South Africa, Tel: +27 (0)11 783 4329, Fax: +27 (0) 865 220 991 E-mail: info@iob.co.za, Website: www.iob.co.za Directors: JE Hodges (Chairman), D Fakir, M Ferreira, IG Kriel, B Makasi, TI Marx, L Ndlovu, H Potgieter, JB Strydom Page 1 of 1