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Make an Impact in 67 Minutes
Mandela Day Registration Form
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
Details of the person completing the registration
Name
*
Email Address
*
Contact Number
*
Company Information
Company Name
*
Postal Address
*
Postal Code
*
Company Registration Number
*
Physical Address
VAT Number
Postal Code (Physical Address)
Time Teams person
Event Details
Venue
*
Venue
Cape Town
Johannesburg
Pretoria
Bloemfontein
Durban
Pietermaritzburg
Number of Teams (1-9)
*
Shift Time 1
Shift Time 1
09:00 – 10:07
11:00 – 12:07
13:00 – 14:07
15:00 – 16:07
Shift Time 2
Shift Time 2
09:00 – 10:07
11:00 – 12:07
13:00 – 14:07
15:00 – 16:07
Shift Time 3
Shift Time 3
09:00 – 10:07
11:00 – 12:07
13:00 – 14:07
15:00 – 16:07
Shift Time 4
Shift Time 4
09:00 – 10:07
11:00 – 12:07
13:00 – 14:07
15:00 – 16:07
Shift Time 5
Shift Time 5
09:00 – 10:07
11:00 – 12:07
13:00 – 14:07
15:00 – 16:07
Shift Time 6
Shift Time 6
09:00 – 10:07
11:00 – 12:07
13:00 – 14:07
15:00 – 16:07
Shift Time 7
Shift Time 7
09:00 – 10:07
11:00 – 12:07
13:00 – 14:07
15:00 – 16:07
Shift Time 8
Shift Time 8
09:00 – 10:07
11:00 – 12:07
13:00 – 14:07
15:00 – 16:07
Shift Time 9
Shift Time 9
09:00 – 10:07
11:00 – 12:07
13:00 – 14:07
15:00 – 16:07
Participation Cost
Participation Cost:
R0.00
Person Responsible for Payment
Name
*
Email Address
*
Contact Number
*
Checkbox
*
By completing the above form, you are signing up your business to participate in a Rise Against Hunger Meal packing event. For each team a donation amount as stipulated above will need to be paid 14 days before the event. Your participation in the event will only be confirmed once an MOU, generated from this form, is signed by a representative of your business and payment is received.
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