QAUUG 2000 Conference Registration
Parkroyal Hotel, Brisbane, 9th May 2000.

This form serves as an invoice.

(One form per person - photocopies acceptable) PLEASE READ CAREFULLY

Section A: PARTICIPANT PERSONAL DETAILS

surname

 first name

 title (Dr/Mr/Mrs/Ms/Miss)
position

 organisation
address
suburb

 state

 postcode
telephone: business

 private

 facsimile
e-mail: (please print)

Section B: PAYMENT OF FEES

CONFERENCE REGISTRATIONS
AUUG / SAGE-AU / ACS Members $90.00 A$....................................
Non-Members $150.00 A$....................................
Student Discount (unwaged) ID No........................ $90.00 A$....................................
AUUG Inc. Membership Individuals: $110, Corporate: $ 429, Student (FT): $ 27.50 A$....................................
(If you join AUUG on this form you are entitled to the AUUG membership rate for the Conference. Membership is valid through to 30 June 2001, and inclusive of 10% GST from 1 July 2000-30 June 2001)
TOTAL PAYMENT A$....................................

Conference registration includes a buffet lunch, morning tea, afternoon tea and post-conference refreshments.

PAYMENT OPTIONS

Cheque/Money Order/Credit Card. Please make Cheques payable to AUUG Inc.  Qld. Chapter.

( ) Cheque ( ) Bankcard ( ) Visa ( ) Mastercard
card number
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
expiry date
 
 
 /
 
 
name on card
signature

NOTE: This Registration Form serves as an invoice.
Registrations accompanied by total payment only will be processed in order of receipt.
Please return this form, plus your cheque/payment to:

OFFICE USE ONLY:

Record No. ....................      Rcd: ..... / ..... /00      Paid A$................      Confirmed ..... / ..... /00     

Remarks

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