PoCUS Accredited CPD Training
Registration Form
Name
*
First Name
Last Name
Email
*
example@example.com
University, Institution or Company details
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
MP registration number
SAAFP Company organisation number [AFP]
Phone Number
*
-
Area Code
Phone Number
Individual or Group booking
*
Individual
Group
Provide list of users [Name, surname, cell phone number, email address and MP registration number
REGISTRATION FEE
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Fundamental [1st TIER] MEMBER
1,200.00
ZAR
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Fundamental [1st TIER] NON-MEMBER
1,400.00
ZAR
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Comprehensive [2nd TIER] MEMBER
1,675.00
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Comprehensive [2nd TIER] NON-MEMBER
1,875.00
ZAR
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Extended [3rd TIER] MEMBER
1,350.00
ZAR
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Extended [3rd TIER] NON-MEMBER
1,550.00
ZAR
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Total
0.00
ZAR
I am interested in doing the next level. [NOTE: An additional fee will be charges - to be comfirmed as this is dependant on the number of candidates, availability and geographics]
Hands on training
Assessments
Additional notes you would like to add.
Please verify that you are human
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