Registration form
Name
Phone Number
Email
Fax Number
All paid up members of the Association for Autism will receive a R50-00 discount.
I would like to become a member
I am already a member
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If other please specify:
BANKING DETAILS:
ABSA Bank Hatfield
Account Name: The Association for Autism
Account Number: 1102 111 849
 Copyright © 2009 Contact Tel : +2712 9934628 Fax : +2712 9934675 Email : afautism@iafrica.com Made with Xara REGISTRATION FORM AUTISM: TOWARDS THE FUTURE CONFERENCE 3-4 March 2011 Please complete all the fields below and email / fax (together with your proof of payment) to: autismadmin@iafrica.com /  012 993 4675 Design by : Nobody Grahpic Design Studio association for autism