EVENTS BOOKING FORM 2017 – MASTERCLASSES - CYCLE 3, CUSTOMER ENGAGEMENT Initial Pages 1-2, full signatures needed on pages 3 and 4. Completing the fields in section A, C, D, E, F, is mandatory. Complete and sign the form and send it back to and PERSONAL DETAILS Surname Forenames (in full) Previous Surname / Maiden Name Country of residence Cell phone number ID Number / Passport nr. Title (e.g. Mr, Ms, Mrs, Miss) Email Address - Primary Email Address - Secondary Residential Address Code Postal Address Code Are you a member of MA(SA)? (tick the Yes No Have you obtained a Designation through Yes No relevant box)? MA(SA)? (tick the relevant box)? If you are Designated, which Designation CM(SA) – Chartered MP(SA) – Marketing MC(SA) – Marketing did you obtain (tick the relevant box)? Marketer South Africa Practitioner South Coordinator South Africa Africa Membership and Designation Details – only to be completed by MA(SA) members MA(SA) Membership Number MA(SA) Designation Number
EVENTS BOOKING FORM 2017 – MASTERCLASSES - CYCLE 3, CUSTOMER ENGAGEMENT Initial Pages 1-2, full signatures needed on pages 3 and 4. Completing the fields in section A, C, D, E, F, is mandatory. Complete and sign the form and send it back to and PERSONAL DETAILS Surname Forenames (in full) Previous Surname / Maiden Name Country of residence Cell phone number ID Number / Passport nr. Title (e.g. Mr, Ms, Mrs, Miss) Email Address - Primary Email Address - Secondary Residential Address Code Postal Address Code Are you a member of MA(SA)? (tick the relevant box)? Yes No Have you obtained a Designation through MA(SA)? (tick the relevant box)? Yes No If you are Designated, which Designation did you obtain (tick the relevant box)? CM(SA) – Chartered Marketer South Africa MP(SA) – Marketing Practitioner South Africa MC(SA) – Marketing Coordinator South Africa Membership and Designation Details – only to be completed by MA(SA) members MA(SA) Membership Number MA(SA) Designation Number