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Event registration form

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

 
I wish to register for...
ALIA New Librarians Symposium 1.5 [5 Dec 2003]
Join us again for a day of personal and professional development for new librarians - and celebratory cocktail party. Find out all the details on our website. Carlton Crest Hotel, Brisbane For more information, contact Robyn Gattera, twq@brisbane.qld.gov.au.nospam.
Please return the completed form with payment to:
ALIA events registrar
PO Box 6335, Kingston, ACT, 2604
fx 02 6282 2249
conferences@alia.org.au.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 New Graduates Group']
Credit card  [please circle one...] MasterCard   Visa   Bankcard   American Express *[security code required]
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*American Express security code:   _  _  _  _
cardholder name and signature  
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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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