Contact details
First name*:
Land line number*:
Last name*:
Cell phone number:
Email address*:
Fax number*:
Company name*:
Type of business*:
Please select
Corporate
PCO
Travel agent
Other
Client company name (booking on behalf of)*:
Postal address 1*:
Physical address 1*:
Postal address 2*:
Physical address 2*:
Postal code*:
Physical address 3*:
Venue
Please select a property*:
Please select
Emperors Palace, JHB, Gauteng
Graceland, Secunda, Mpumalanga
Frontier Inn, Bethlehem, Free State
Khoroni, Thohoyandou, Limpopo
Mmabatho Palms, Mafikeng, North West
Rio, Klerksdorp, North West
Mondazur, San Lameer, KZN
The Grand Palm, Gaborone, Botswana
Taung, Taung, North West
Umfolozi Inn, Empangeni, KwaZulu Natal
Conference Requirements
First conference date*:
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
January February March April May June July August September October November December
2008 2009 2010 2011 2012 2013
Last date of conference*:
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
January February March April May June July August September October November December
2008 2009 2010 2011 2012 2013
Total number of delegates*:
Seating*:
School room
U shaped
Cinema
Number of venues:
Number of delegates per venue*:
Banqueting/Special Events Requirements
Type of event:
Breakfast
Lunch
Cocktail
Dinner
Product launch
Exhibition
Accommodation Requirements
Do you require accommodation?*:
Yes No
Arrival date:
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
January February March April May June July August September October November December
2008 2009 2010 2011 2012 2013
Number of rooms:
Departure date:
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
January February March April May June July August September October November December
2008 2009 2010 2011 2012 2013
Room configuration:
Please select
Single
Sharing/Twin
Sharing/Double
Other Requirements
Other requirements: