Delegate Registration Form Title * Name * First Name Last Name HPCNA Number * Email * Phone (###) ### #### Academic Institution Special Dietary Requirements NDA MEMBER Early Bird (until 14th of August)- N$ 4 900 NON-NDA MEMBER (INCLUDING SADA MEMBERS)- N$ 8 000 Will you attend Congress Evening Gala on Friday 26/09/25 (price included in the congress fee) Yes No Will you bring a plus 1 (additional cost of N$ 1 000)? Yes No Thank you for your submission!NDA Member N$ 4 900 (Early Bird)Non NDA Member- N$ 8 000Additional N$ 1 000 for a ‘plus 1’ for a Friday Night GalaKindly make a payment to:Bank WindhoekBranch 483 872Maerua MallAccount no 8000 664 742
