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Accommodation Booking Request
Conference Booking / Quotation Request

Please completed the form below and we will contact you to confirm your request.
Looking forward to seeing you at Ezingweni Safari Lodge and Day Bush Spa.

Conference Co-Ordinator's Personal Details

Last Name
First Name
Company Name
Position Held
Work Tel
Work Fax
Cell phone
Email Address
Postal Address
Physical Address

Conference Programme Schedule (Normal Timings in Brackets)

Preferred Date
for Conference
Arrive Date :
Depart Date :
Preferred Timing
for Conference
Breakfast (08:15) -

 

Mid Morning Break (11:00) -

 

Lunch (13:00) -

 

Mid Afternoon Break (15:00) -

 

Dinner (20:00) -

Delegates Details

Number of Delegates

Number of Rooms Required

x Males x Females x Single x Sharing

Meals

Special Dietary Requirements

Extras for Meals

Conference Requirements

Seating Plan

U-Shape Boardroom Classroom Theatre
Other (please state)

Visual Aid

AV Projector Overhead Projector
Flip Chart White Board
Television Video Recorder (VCR)
Slide Projector DVD Player
Stationery Whiteboard and Flip chart Pens, Ballpoint Pens,
Pencils and Notepaper are provided on payment.

Additional Comments / Requests


I confirm all details above are correct

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