I am applying for the the Woman Within® Weekend hosted by Women for Afrika.
All information provided will be treated as confidential.

1. Personal Information

2. Date of birth

Date of birth

3. Occupation and Marital status

The Woman Within Training® Course is presented in English.

4. Do you speak English?

5. What is your 1st language?

6. Which weekend would you like to attend?

Investment Options:
The investment for the weekend is R4900, this covers international facilitators fee and airfare as well as the royalties to Woman Within International.
It also covers your tuition, accommodation, meals, snacks and training material.

Below are payment plan options to support you.
*Plan 1: R200 discount for full payment of R4700 before 1st April 2018. This includes the R1000 non-refundable deposit.
*Plan 2: Non-refundable R1000 deposit with balance due 21 April 2018.
*Plan 3: Non-refundable R1000 deposit with individual payment plan. Please email registrations@wfa.co.za with your proposed payment plan.

7. Payment plan

As numbers are limited it is essential to make your payment in full or pay your R1000 non-refundable deposit on registration in order to secure your place. Your place is not secured without a payment and so you will automatically be placed on the waiting list until we receive your payment.

Cheques to be made payable to Women for Afrika, or Direct Deposits to be paid into the following account:

Account Name: Women for Afrika
Bank: ABSA
Account No: 4062350809
Branch No. 632005
Reference: "Your Full Name" and the word "WfAW"
Please note that your booking will only be confirmed once we receive your proof of payment. Therefore please send your proof of payment to: Registrations@wfa.org.za.
Cancellation policy:
A full refund, less the R1000 non-refundable deposit, will be made if we receive your cancellation notice in writing no less than 14 working days prior to the first day of the Weekend for which you have registered.
If we receive your cancellation less than 14 working days prior to the weekend, you will not receive any refund. If however your cancellation is due to medical reasons, a medical certificate will be required and you will receive a full refund, less the R1000 non-refundable deposit.

8. Cancellation policy

Securing your place:
Your final payment will be due 14 days prior to your weekend as this is also the cut off for cancellations.  If we do not receive your payment by then, you will automatically be placed at the back of the waiting list.
If you have a payment plan in place this does not apply to you.

9. I understand the conditions for securing my place

Do you wish to receive information about future Woman Within ® or Women for Afrika workshops.
(if you choose to receive information, we will hold your details in our database and keep you informed of events in the Community. Your details will not be given to any third parties).

10. Receive information

By printing my name below, I agree that all information provided in this form is true and correct.

11. Name and date

Enroll early! Space limited to 32 participants with proof of payment.

An honouring ceremony evening will be held on Monday evening the 14th of May 2018 in Cape Town at 7pm. Dates for Johannesburg will be confirmed nearer the time. You may want to invite your family and friends to be with you on this special occasion to celebrate you! Venue details will be provided to you on your weekend.