Location: Gallagher Estate, Midrand

Date: 8th May 2022

Registration Form - Virtual & Gallagher conference - 8th May 2022

MP Number

Title

Name

Practice Address

Street Name & Number Street Name or Building Name Suburb City Postal Code Country

Office Number

Mobile Number

Do you belong to an IPA?

Yes

If Yes, Please Specify

Please Select type of booking *

Nb: Virtual meeting link will be sent via email once payment is secured

All meals are Halaal Certified. Vegetarian meals are included in our lunch menu