40th Annual IMASA Convention Registration

Name
Surname
Physical Address
Tel (Work)
Tel (Home)
Cell*
Email
Fax
HPCSA Number
Profession/Speciality
Spouse Name & Surname (Non-Medical, if attending)
Children's Name, Surname & age (if attending)
Select who & how many will be attending:
PLEASE NOTE:
info
- If your spouse is also a health professional and requires the CPD accreditation, he/she will have to register separately as a delegate.
- Rates are subject to change every year
Doctors, Dentists, Pharmicists - IMA Member
Price: R3,000.00 Quantity:
Doctors, Dentists, Pharmacists (Non-Member)
Price: R3,500.00 Quantity:
Allied Health Professionals - IMA Member
Price: R2,500.00 Quantity:
Allied Health Professionals (Non-Member)
Price: R3,000.00 Quantity:
Nurses, Dental Assistants, Paramedics - IMA Member
Price: R2,000.00 Quantity:
Nurses, Dental Assistants, Paramedics (Non-Member)
Price: R2,500.00 Quantity:
Spouses (Non-medical)
Price: R2,500.00 Quantity:
University Students (18 Years +) IMA Members
Price: R1,900.00 Quantity:
University Students (18 Years +) (Non-Member)
Price: R2,400.00 Quantity:
Youth (12 - 18 Years)
Price: R1,700.00 Quantity:
Children 0 - 2 Years
Price: R0.00 Quantity:
Children 3 - 11 Years
Price: R1,000.00 Quantity:
Day Delegate Member
Price: R2,000.00 Quantity:
Day Delegate (Non-Member)
Price: R2,500.00 Quantity:
Total Due:
R0.00
Attending Gala Dinner On 8 August 2020*
- Yes
- No
Attending Braai On 9th August 2020*
- Yes
- No
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CPD ACCREDITATION APPLIED FOR

FOR FURTHER INFORMATION CONTACT:

imakzn@baytulnur.org.za / imaadmin@baytulnur.org.za | Shirin Cassim / Zeenath Khan: +27 31 209 7838

Accommodation booking must be done directly with the hotel: +27 31 5695988

Download accommodation form here

Renewal and new membership registration available at the convention

TERMS & CONDITIONS

Early Bird Registration ends on the 30th June 2020
Only fully paid-up delegates will be allowed access to the convention – click on the PAYFAST APP link for your convenience
Please note that your registration should be done online
Name changes are accepted within the same registration category
Delegates are responsible for their own booking of Travel & Accommodation arrangements

CANCELLATIONS & REFUNDS

All requests for registration cancellations and refunds to be forwarded in writing to imakzn@baytulnur.org.za
Before 01st June 2020: 90% refund
From the 01st June till 30th June- 75% refund
01st July – till convention dates: 50% refund
No refunds after 08th August 2020
NOTE: refunds are processed AFTER the convention once all reconciliations are complete

Select who & how many will be attending: