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...
ALIA New Graduates are invited to dinner [22 Sep 2004]
during the ALIA Biennial conference to catch up with colleagues. Guest speaker: Kay Raseroka, IFLA president. Conrad Jupiters, Broadbeach Room, 7:00pm sharp. Payments via reg form by 17/9, payments will not be accepted on the evening.$25.00 ALIA members, $25.00 non-members [GST incl].
For more information, contact Simone Friend, s.friend@griffith.edu.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]
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.
How do we use the data that you enter into this form? Check our privacy statement.
