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Australian Library and Information Association	Tax invoice
ABN 40 090 953 236	This document will be a tax invoice for GST purposes when you make payment

Event registration form

Please print this form, complete the details, and return as instructed below.

I wish to register for...	[17 Oct 2008] Time: 9.00 am to 5 pm. Venue: Menzies Room, National Archives of Australia, Queen Victoria Terrace, Parkes, ACT. Full rates: $143.00; ALIA/LIANZA/ASA member $121.00; Student $66.00$TBA ALIA members [GST incl]. For more information, contact Jenni Jeremy, jenni.jeremy@unisa.edu.au.nospam.
Please return the completed form with payment to:
	.nospam (please remove'.nospam' from address)
given name
family name
postal address
ph		fx
e-mail
employer (if applicable)		position/title
additional information [is this a day registration, do you have any dietary requirements, do you qualify for concession rates, or anything else not mentioned elsewhere?]
student number?		If applicable. Only full-time students qualify for student rates if they are offered.
ALIA membership number		If empty or invalid, non-member prices will be charged
total payment for event All prices are given above in $AUD and include GST			$
I am paying by...	Cheque [cheque or money order payable to 'ALIA Acquisitions (National)']
	Credit card [please circle one...]	MasterCard Visa Bankcard American Express *[security code required]
card number	_ _ _ _ \| _ _ _ _ \| _ _ _ _ \| _ _ _ _		expiry _ _ / _ _
*American Express security code:			_ _ _ _
cardholder name and signature	X
pay by EFT/invoice	Contact ALIA National Office for the correct account details if you would like to pay for events or services by EFT. If you need to be invoiced for payment, contact the events co-ordinator (please remove '.nospam' from address) at ALIA National Office [ph 02 6215 8235] or by fax at the number above. Member institutions can register one or more employees for events at member rates, depending on their level of membership. Please refer to our membership benefits pages for details.
cancellation fees	Please note that if you cancel your registration within four weeks of the event date, a cancellation fee of 70 per cent will apply. Registrations can be transferred to other people at no charge.
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