Delegate Registration

Please read and complete the form below.

You will need your and your partner's Identity documents to upload ( jpg, png, gif, pdf, or word doc/docx ).

Employee Information

Sanlam Qualifier Paycode*

Qualified years*
The number of years you have qualified for the SanlamConnect National Convention including this year

Sanlam Branch*

Sanlam Branch Address*
Office address for courier purposes
No PO Box addresses

Title*

Full First Names*
Exactly as on ID/Passport

Other Names
Exactly as on ID/Passport

Surname*
Exactly as on ID/Passport

Preferred Name
For nametags and other material

Date Of Birth*

Contact Number*

Cell Number*

Email Address*

Medical Conditions

Food Allergies

Dietary Requirements*

Shoe Size*

Men: US ~ UK + 0.5 & EU ~ US + 33
Women: US ~ UK + 2 & EU ~ US + 31

Title
Partner's Title

Partner's Full First Names
Exactly as on ID/Passport

Partner's Other Names
Exactly as on ID/Passport

Partner's Surname
Exactly as on ID/Passport

Cell Number

Medical Conditions

Food Allergies

Dietary Requirements

Shoe Size

Men: US ~ UK + 0.5 & EU ~ US + 33
Women: US ~ UK + 2 & EU ~ US + 31

Emergency Contact Name*

Emergency Contact Number*

Relationship to Attendee*

Upload Your Identity Document
SA ID, Drivers License or Passport

Upload Your Partners Identity Document
Partner's SA ID, Drivers License or Passport