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Conference Social Function – Add

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					                          Conference Social Function – Additional Tickets
  Please print clearly and retain a copy of your registration for your records. Please forward to the conference NCCARF 2010 Secretariat: - YRD (Aust) Pty
                                  Ltd, PO BOX 717, INDOOROOPILLY QLD 4068 ℡ Tel: 07 3368 2422              Fax: 07 3368 2433
                                                                Email: nccarf-conf2010@yrd.com.au


  A. DELEGATE DETAILS
  Title: _________ First Name: ______________________________________ Surname: ____________________________________
  Mobile: ____________________________________________ Business Tel: _____________________________________________
  Email: ______________________________________________________________________________________________________


  B. ADDITIONAL TICKETS

  Attendee Name:______________________________________________________________________________________________
  Attending:           Welcome Reception                  Conference Dinner
  SPECIAL REQUIREMENTS (e.g. dietary, health, physical disabilities etc): _________________________________________________


  Attendee Name:______________________________________________________________________________________________
  Attending:           Welcome Reception                  Conference Dinner
  SPECIAL REQUIREMENTS (e.g. dietary, health, physical disabilities etc): _________________________________________________


  Attendee Name:______________________________________________________________________________________________
  Attending:           Welcome Reception                  Conference Dinner
  SPECIAL REQUIREMENTS (e.g. dietary, health, physical disabilities etc): _________________________________________________


  Attendee Name:______________________________________________________________________________________________
  Attending:           Welcome Reception                  Conference Dinner
  SPECIAL REQUIREMENTS (e.g. dietary, health, physical disabilities etc): _________________________________________________


  C. PAYMENT SUMMARY
    Welcome Reception ticket (Tuesday, 29th June)                             AUD$55 (incl. GST)          X _____________ = ___________

    Conference Dinner ticket (Wednesday, 30th June)                           AUD$110 (incl. GST) X _____________ = ___________


    Cheque payable to: YRD (Aust) Pty Ltd NCCARF Account                                         Please charge my credit card for the above amount*
Card Type:             Mastercard             Visacard          American Express

Card No. ___ ___ ___ ___ / ___ ___ ___ ___ / ___ ___ ___ ___ / ___ ___ ___ ___                                  Expiry Date ____ / ____


Card Holders Name ___________________________________ Signature ___________________________________________
* please note all credit card payments are subject to a 2.5% Credit card processing fee

I agree to the cancellation policy as outlined on this form.

Signature___________________________________________________________                                        Date__________________________________
                                                                th
Cancellation Policy: Refunds will be available until Tuesday 15 June. Refunds after this date will be at the discretion of the Conference committee.

				
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