Acino

Gala Dinner Attendance

Will you be attending the Gala Dinner at the @Sandton Hotel in Sandton?
Date: Tuesday, 3 June

Yes No

Personal Information

Title

First Names
As per passport

Surname
As per passsport

Preferred Name
For badges etc

ID or Passport Number

Cell Number

Email Address

Travel Information

Do you require a flight?

Yes No

Accommodation has been arranged at the @Sandton Hotel.

Please note that staying over is voluntary.
Accommodation is provided for safety purposes.
Acino bears no liability for any harm that may occur during your journey home following the awards dinner.

I require accommodation.

Who would you like to share with?

Kindly advise your preferred sharing colleague for accommodation.
Please ensure that you and your colleague are aligned before completing the RSVP.

First Choice:

Second Choice:

Region

Medical & Dietary Information

Do you have any Medical Conditions
i.e. Asthma, Allergies, Disabilities etc.

Dietary Requirements

Additional Information and Comments

Additional Comments