Shepherd Registration Form / Registrasievorm

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* required fields / verpligte velde

*Name / Naam:
*Address / Adres:
*
*Postal code / Poskode:
Country / Land:
*Phone / Telefoon:
Cell / Selfoon:
*e-Mail / e-Pos:
   
*Are you a member of the Intergis ? / Is u lid van die Intergis ? Yes/Ja      No/Nee
   
*Name for income tax invoice/ Naam vir belastingsfaktuur

 

Price/Prys:    R 2850.00   (All inclusive for South Africa. Other countries, please enquire)

 

Instructions / Instruksies:

 

Send a copy of electronic payment to: / Stuur 'n afskrif van elektroniese inbetaling aan:

SA VAGTOETSSENTRUM

Attention: Arno van Graan

Privaatsak X 529

MIDDELBURG

Oos-Kaap

5900

Phone: 049 842 2563

Fax     : 049 842 1343

Bank Details / Bank Besonderhede

Account Name: ARC Receipt Account

Bank: Standard Bank

Branch code: 001545

Account Number: 012588792

We will send your copy of Shepherd to the supplied address as soon as we recieve your payment. / Ons stuur u Shepherd program sodra ons u betaling ontvang het.