Section 1 |
| Title |
First Name
|
| Family Name |
|
| Badge Name |
(only if different from above) |
| Job Title |
|
| Division |
|
| Organisation |
|
| Address Line 1 |
|
| Address Line 2 |
|
| Suburb/City |
|
| State |
Postal
Code
|
| Country |
(Required) |
| Business Phone |
Business Fax
|
| Mobile Phone |
|
|
| E-Mail Address |
please ensure address is spelt correctly |
| |
Is this your Work Address?
|
| Special Dietary Requirements |
|
| Other Requirements |
wheelchair access etc |
| Send Correspondence |
E-Mail
|
Fax
|
Mail
|
|
|
|
|
Accompanying Person Information
You only need to complete
this section if you will be purchasing extra function tickets or
sharing a room with your non delegate partner. |
| Title |
|
| First Name |
|
| Surname |
|
| Badge Name |
(only if different from above) |
| Special Dietary Requirements |
|
|
Section 2 - Full Registration |
|
Full Registration includes:
Attendance to all Forum Sessions, Ticket to Official Civic
Reception, Access to Exhibition area, Forum satchel with
complete program, Morning and Afternoon Teas DAILY, Lunches DAILY
Tickets to attend
the Gala Dinner can be purchased in section 3, you may also
purchase extra tickets to the Official Civic Reception in section
3. |
| Registration Type |
|
($AUD) |
|
The Official Civic Reception is included in registration.
Please indicate whether you will or will not attend the Official
Civic Reception.
I will attend
the Official Civic Reception
|
|
|
|
Section 3 - Social Function Tickets |
The Official Civic Reception (26th
September 2007) is included for
all Full Registrations.
The Gala Dinner (27th September
2007) is
not included in the Full Registration, delegates can purchase
Gala Dinner tickets below:
Gala Dinner Tickets for delegates are
$125.00 each
Extra Official Civic Reception Tickets are $60.00
each
Australian Outback Spectacular Tickets are
$99.00 each
(Subject to availability - limited tickets
available)
|
Total Registration Amount Due ($AUD)
|
|
|
|
|
| Section 4 - Hotel Booking Information |
Please note: If sharing a room, split deposit payments for accommodation can not be accepted.
Your hotel booking is not confirmed until
you provide a credit card number. Please follow the links after
you have submitted this form.
DO NOT book a room if you are sharing with
another person with a room booking.
Special discounted room rates are
available for delegates at the Legends and Q1 and
need to be booked through the Forum Secretariat.
|
Legends Hotel
Standard Room per night
Twin (Queen beds) $140/night.
Studio Room per night
Double (King bed) $145/night
|
Q1 Apartments
Apartment per night (1 brm)
One bedroom luxury apartment with fully self contained
kitchen, spa bath with separate shower, personal safe &
broadband connection.
$239.00/night |
To take advantage of these discounted
rates please book here.
Please note: Credit card details
will be required as a deposit by the venue you book. These
details will be held on file by the Forum Secretariat and passed
on to the venue of your choice. Venues may or may not choose to
process your credit card to the value of the first nights
deposit. All hotel accounts need to be finalised on check out.
Once you have submitted this
registration form, you will be directed to a secure gateway to
lodge your credit card details for any accommodation bookings
you may make.
If booking accommodation please make a
selection from all fields in
BLUE
Hotel |
|
Room Type |
|
Arrival Date |
|
Arrival Time |
|
Departure Date |
|
|
Note: Single (queen bed) - Double (king bed)
Twin (queen beds) |
| Sharing room with nominated accompanying person
|
|
|
| Special Requirements
|
Hotel Deposit Due ($AUD) |
|
|
|
|
|
|
| Section 5 - Payment Method -
for
Conference only (not accommodation) |
