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STANDARD REGISTRATION FORM – FRIDAY 30 OCTOBER 2015

Let's Talk about Financing AGribusiness & Export/Trade Projects & Initiatives


AN ADC BUSINESS NETWORK INITIATIVE IN PARTNERSHIP WITH
THE WESTERN CAPE EXPORTERS CLUB

 
 
COMPANY / ORGANISATION *
POSTAL ADDRESS *CITY *
COUNTRY *POSTAL CODE *
TELEPHONE NUMBER *FAX NUMBER
CONTACT PERSON *EMAIL ADDRESS *
VAT REGISTRATION NUMBER
DELEGATES
 TITLE *INITIALS *FIRST NAME *SURNAME * POSITION *
1.
2.
3.
4.
REGISTRATION FEES
COST PER DELEGATE

¹

R650.00R0.00
TOTAL PAYABLE

²

FOR THE ABOVE 0x DELEGATES – NO VAT CHARGED
R0.00

¹

INCLUDES WORKSHOP AND NETWORKING FUNCTION

²

ALL FEES ARE PAYABLE IN ADVANCE BY DIRECT DEPOSIT OR ELECTRONIC BANK TRANSFER

 
BANK DETAILS
Please send a copy of the deposit slip to info@agri4africa.com or fax the proof of
payment to +27 (0)28 272 9853.
Use A4A-9J94B3 as reference number.
ACCOUNT NAME.  Agribusiness Development
ACCOUNT NUMBER.  072295422
BANK.  Standard Bank Helderberg
BRANCH CODE.  033-012(42)
QUESTIONNAIRE – PLEASE BE SO KIND TO ASSIST US BY ANSWERING THE FOLLOWING QUESTIONS
1.  ANY SPECIFIC QUESTIONS ON FINANCING INSTRUMENTS, BUSINESS GRANTS AND INCENTIVES? 
2.  IF ALREADY WORKING IN AFRICA, IN WHICH COUNTRIES? 
3.  ARE YOU UTILISING THE DTI-EMIA EXPORT INCENTIVE SCHEME? IF SO, WHICH PART? 
4.  COMMENTS / SUGGESTIONS 
SECURITY CODE *
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