Registration 29th ACI AGM

South Africa

Registration Form AGORA International Conference 2025

Name *

First

Last

Country of Residence

Email *

Tel/Whatsapp

Emergency Contact Person Info

Name, phone number, relationship

Date of Arrival

Travel Information

Name and Number of Agora Club

Current Agora Club Portfolio:

Current Agora National Portfolio:

Previous Portfolios on the ACI Board:

Dietary Requirements

Dietary Requirements Notes (If Required)

Do you have any Allergens?

Conference Package Selection

Councillor
Delegate

COUNCILLORS PACKAGE; Councillors Meeting & Lunch, Welcome Party, AGM & Lunch, African Chic Boma Dinner & Goody Bag.
~ Early Bird Rate €275 EUR
~ Tortoise Rate €290 EUR

DELEGATES PACKAGE; Welcome Party, AGM & Lunch, African Chic Boma Dinner & Goody Bag.
~ Early Bird Rate €235 EUR
~ Tortoise Rate €250 EUR

Please note: All registrations received after 30 April 2025 will be subject to the Tortoise Rate.

Will you be bringing a partner / guest to accompany you?

Please note: This information is for our planning purposes only and does not create any obligation. Should your plans change, there will be no issue or penalty.

If yes, Partner's name?

Partners Package Selection

Partner

PARTNERS PACKAGE; Welcome Party , African Chic Boma Dinner.
~ Rate €150 EUR

Pre-Conference Excursion

Entabeni Safari Conservancy

Please note: This information is for our planning purposes only and does not create any obligation. Should your plans change, there will be no issue or penalty.

Post Conference Tour

Pilansberg: Bakubung with Sun City Day Trip

Please note: This information is for our planning purposes only and does not create any obligation. Should your plans change, there will be no issue or penalty.

Are you using a shuttle service or your own transport / car hire?

Shuttle Service
Own Transport / Car Hire

Please note: This information is for our planning purposes only and does not create any obligation. Should your plans change, there will be no issue or penalty.

Info car of

Which Lodge have you chosen for your accommodation?

Please note: This information is for our planning purposes only and does not create any obligation. Should your plans change, there will be no issue or penalty.

Anything else we should know?

The AGORA CLUB South Africa's
banking details are as follows;

Bank Name: STANDARD BANK

Account Holder: AGORA CLUB SOUTH AFRICA

Account number: 654968942

Branch Code: 002549

SWIFT CODE : SBZAZAJJ

Bank Address: Makhodo Crossing , Makhado, Limpopo Province

Registration 29th ACI AGM

South Africa

Registration Form AGORA International Conference 2025

The AGORA CLUB South Africa'sbanking details are as follows;

The AGORA CLUB South Africa's
banking details are as follows;