APPLICATION FOR PRE-REGISTRATION

EXPO CENTRE, NASREC,

JOHANNESBURG

13 - 15 September 2011

9am - 5pm daily

AFRIWATER EXHIBITION ENTRY POLICY:
Persons under  age 16 not admitted. Student  groups by prior arrangement only. Disclaimer: Right of admission reserved. By completing  this ticket and entering  the show, I agree  to be contacted in a business capacity via the  Afriwater Database

      

PLEASE COMPLETE THE SECTIONS BELOW AND SUBMIT
     
  Title :
  First Name :
  Surname :
  Company  :
  Postal Address 1:
  Postal Address 2:
  City / Town :
  Postal Code :
  Country :
  Telephone :
  Cell :
  Fax :
  E-Mail :
     
To opt out of e-communications from us please check this box:
 

WHAT IS THE  MAIN ACTIVITY OF YOUR ORGANISATION ? (tick one box)
 
  1     Municipalities  
  2     Water Boards  
  3     Mining  
  4     Industry  
  5     Engineering & Manufacturing facilities  
  6     Local & Central Government  
  7     Agriculture  
  8     Chemical  
  9     Institutes  
  10     Universities & Training facilities  
  11     Petrochemical  
  12     Pulp & Paper  
  13     Other (please specify)  
         

 
 

WHAT IS YOUR MAIN JOB CATEGORY ? (tick ONE box) 
           
  1     Owner / Managing Director / CEO
  2     Government/Municipality Official
  3     Production Director/Manager
  4     General Manager/Project Manager
  5     Mining/Factory Manager
  6     Foreman/Supervisor/Production Planner
  7     Quality Controller
  8     Chemical Engineer
  9     Civil Engineer
  10     Buyer/Procurement
  11     Systems Specialist
  12     Research & Development
  13     SHEQ
  14     Other (please specify)
         
 
 

Disclaimer: Right of admission reserved. By completing this ticket and entering the show, I agree to be contacted in a business capacity via the Afriwater Database