Sponsorship Registration form

27th Annual Family Practitioners Congress - Sponsorship Registration Form
Company Name*
Vat Number*
Billing address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Procurement contact details

First NameLast Name
Company Representative*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Sponsorship packages
My Products
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Diamond Sponsorship
175,000.00ZAR



Platinum Sponsorship
125,000.00ZAR



Gold Sponsorship
100,000.00ZAR



Silver Sponsorship
55,000.00ZAR



Bronze Sponsorship
35,000.00ZAR



Invited Speakers
25,000.00ZAR



Student\Undergraduate or registrar sponsor [excluding travel and accomodation]
3,500.00ZAR



Symposia
45,000.00ZAR Select the Symposia from the dropdown list below



Congress CateringR50000 per day
50,000.00ZAR Quantity



Poster Session
35,000.00ZAR



Congress Notebooks275 books @ R85 ea
23,375.00ZAR



Registration sponsor
32,500.00ZAR



Exhibition stand 3m x3m 8 stands available.Remember to select your prefered stand in the section below. First come, first served.
10,000.00ZAR



Exhibition Stand 3m x 5m4 Stands available. Remember to select your preferred stand in the section below. First come, first served.
15,000.00ZAR



Total

0.00ZAR