WORKSHOP REGISTRATION

Name and Surname *
Email address *
Cell phone *
Are you currently working on a manuscript?	Yes No Planning to start
What gentre best describes your work?	Fiction Non-Fiction Poetry Biography / Memoir Children's Books
Other genre: please elaborate
Do you consent to being contacted via email or WhatsApp regarding this workshop and future events by Mel J? *	No Yes, but only for this workshop Yes, for this workshop and all events involving Mel J
	I confirm that the information provided is correct and understand that my place at the workshop is only confirmed once proof of payment has been submitted and received. (Follow payment instructions below): *
Consent & Privacy Notice: By submitting this form, you consent to Mel J collecting and processing your personal information for the purpose of workshop registration, communication, and confirmation. Your information will be handled in accordance with the Protection of Personal Information Act (POPIA) and will not be shared with third parties without your consent. *	I agree to the collection and use of my personal information for this purpose.

💳 PAYMENT INSTRUCTIONS:

Please make payment using the banking details below:

Account Holder: DM Jacobs
Bank: Capitec Bank
Account Type: Savings
Account Number: 1578428724
Branch Code: 470010

🔔 IMPORTANT:

Use your full name and surname as the payment reference.

Your place at the workshop is only confirmed once proof of payment has been received.

📩 Submit Proof of Payment

After making payment, please send your proof of payment to ONE of the following:

📧 Email: info@melj.co.za
📱 WhatsApp: 062 016 5128

You will receive a confirmation message once your payment has been verified.