Welcome to the Pan African Health Medical Breakfast Registration Form

Please complete the details below to register for the Medical Breakfast at the
Pan African Health Exhibition & Conference at Gallagher Convention Centre on
Friday 17th September at 08h00.

By completing and submitting this form, you acknowledge that this breakfast is at no charge for hospitals, medical specialists, doctors, Nursing Directors, Clinical Managers, Admin Managers, Hospital Managers, Hospital Procurement personnel, Doctors, Department of Health Regional Managers and Health Officials from National Government, but as space is limited places will be allocated on a strictly first-come first-served basis. You will be contacted with confirmation details shortly.

 Exhibitors may attend free of charge.  Non exhibiting medical equipment or technology companies may register for the breakfast at R250.00 per person plus VAT.  Please complete the form below.
We will contact you to confirm your details and arrange payment if you are a pharmaceutical company.

 

 

Your Name & Surname: (required)
Your position/designation
Your Company Name:
Company/Institute activity
If Other:
Daytime Contact Number: (required)
Email address: (required)
I am an exhibitor & I wish to attend the Breakfast

I am an exhibitor and am entitled to attend this breakfast at no charge.
I am part of a medical supply company

  I understand and agree my company will be billed R250 for me to attend this breakfast. (Please tick)
I am interested in Sponsoring this breakfast