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CONFERENCE REGISTRATION FORM

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					                                      CONFERENCE REGISTRATION FORM
                 The preferred method of registration is via the web at: http://www.lymphology.asn.au/

   ABN: 27 091 290 505                                 TAX INVOICE                           Date: ___ / ___ / ___
                                                                                     th
This form allows you to register to attend the Australasian Lymphology Association 8 Biennial Conference
Please print in block letters and keep a photocopy for your record. One form per person please.
Note that all prices quoted are in Australian dollars (AUD) and inclusive of Goods and Services Tax (GST). Please
note that GST of the accommodation deposit will be included in the final balance of accommodation paid on check
out.

By completing this registration form you have read, understood and agree to both cancellation policies and the
privacy statement as stated on the form and on the website.

For further information regarding this registration please contact the Conference Office on:

Think Business Events - ALA@thinkbusinessevents.com.au
Ph: +61 3 9417 1350
Fax: +61 3 8610 2170

Contact Details
   Mr       Ms      Mrs       Miss       Dr      Professor           Other (please specify):

Surname:                                                                  First Name:

Organisation:

Position:

Address:

Suburb/Town:

State:                                                Country:                                       Zip/Postcode:

Bus Telephone:                                                             Bus Fax:

Mobile Telephone:                                                          Home Telephone:

Email:

Delegate Information
How did you find out about the Conference?

   Colleague told me                               Direct email notification                         Journal advertisement
   Newspaper article                               Received information in the mail                  Website search
   Workplace notice board

Book of Proceedings
A book of proceedings will be printed of all received papers. If purchased these will be available for pick up from the
registration desk at the Conference.

                                      Early Bird - Paid by 17 May 2010                  Full Price - Paid after 17 May 2010
Book of proceedings                             _____ x AUD$28                                  _____ x AUD$38

TOTAL:



ALA 8th Biennial Conference, 27 – 29 May 2010, Melbourne Australia
Conference Registration ($AUD inc GST)

                                                                               Early Bird                              Full Price
Registration Type
                                                                         Paid by 10 March 2010                 Paid after 10 March 2010
ALA Member Registration                                                          AUD$865                                AUD$975
ALA Non Member Registration                                                      AUD$955                                AUD$1085
Student Registrations (Full Time Students)                                       AUD$440                                AUD$440
Day Registration -
                                                                                   AUD$355                                 AUD$355
  Thursday Friday Saturday
                                                          TOTAL:

To qualify for a reduced registration, registration fees must be received by the published date. Registration fees are based on date of payment
receipt, not the date of receipt of registration form.
   Student Registration is for full time students, student ID is required for verification upon collection of name badge at the conference.

Inclusive Social Functions
1. The Welcome Reception is included in the cost of a Full Conference Registration fee (excluding Students and
   Day Registrations).

2. The Conference Dinner is included in the cost of a Full Conference Registration fee (excluding Students and
   Day Registrations).

      For catering purposes, please indicate if attending:

           Function                               Venue                                      I will be attending
           WELCOME RECEPTION
                                                  The Sebel Albert Park                         Yes           No
           Thursday 27 May 2010
           CONFERENCE DINNER
                                                  The Sebel Albert Park                         Yes           No
           Friday 28 May 2010


Additional Tickets
1. Additional tickets may be purchased for the Welcome Reception by Day Delegates, Student Registrants and
   for Partners or Guests, please indicate below if you would like to purchase tickets to this function.

2. The Breakfast Session is an optional session and NOT included in the cost of the Conference Registration fee.
   If you would like to attend this session be purchase tickets below

3. Additional tickets may be purchased for the Conference Dinner by Day Delegates, Student Registrants and for
   Partners or Guests, please indicate below if you would like to purchase tickets to this function.

           Function                               Venue                                      Number of Tickets/Cost
           WELCOME RECEPTION                                                                 ____ x $65 inc GST
                                                  The Sebel Albert Park
           Thursday 27 May 2010
           BREAKFAST SESSION                                                                 ____ x $35 inc GST
                                                  The Sebel Albert Park
           Friday 28 May 2010
           CONFERENCE DINNER                                                                 ____ x $110 inc GST
                                                  The Sebel Albert Park
           Friday 28 May 2010

Dietary Requirements – Please indicate any special dietary requirements

Delegate
  Vegetarian                      Vegan                    Gluten Free                  Halal            Orthodox Kosher
    I have an allergy to:

Guest
  Vegetarian                      Vegan                    Gluten Free                  Halal            Orthodox Kosher
    I have an allergy to:


ALA 8th Biennial Conference, 27 – 29 May 2010, Melbourne Australia
 Accommodation
The Conference Office has secured competitive rates for delegates at selected hotels and apartments in Melbourne, to suit a range of budgets and
preferences. Accommodation facilities are easily accessible to the conference venue, and provide a comfortable and enjoyable stay for delegates.
Rooms can be booked through the Conference Office up until Monday 26 April 2010. After this date bookings are subject to availability.
                         Please mark your preference numerically in sequential order – up to three preferences:
To secure a hotel accommodation booking, a deposit of one night’s tariff is required, which must accompany the registration form.

                                                                                                                            RATE – Room Only
               HOTEL                                                   ROOM TYPE                                            The rates below are
                                                                                                                             per room per night


                                        Sebel Queen (One Queen bed)                                                              AUD$175.00

 The Sebel & Citigate Albert
 Park                                   Sebel Twin (Two Queen beds)                                                              AUD$175.00
 4.5 Star Rating
 Conference venue
 65 Queens Rd, Melbourne                Citigate King (One King bed)                                                             AUD$155.00


                                        Citigate Twin (Two Single beds)                                                          AUD$155.00

                                        1 Bedroom Apartment (One King size bed or Two Single beds)                               AUD$157.00

                                        2 Bedroom Standard Apartment (Two King size beds that can be split
                                                                                                                                 AUD$215.00
 Quest on St Kilda Road                 into singles)
 4.5 Star Rating
 10 minutes walk from venue             2 Bedroom Deluxe Apartment (One King size bed and Two single beds,
                                                                                                                                 AUD$230.00
 1A St Kilda Road, St Kilda             or 2 Kings, or 4 single beds)

                                        2 Bedroom Executive Apartment (One King size bed and Two Single
                                                                                                                                 AUD$250.00
                                        Beds, or 2 Kings, or 4 single beds)

                                        Studio Room (One Queen bed)                                                              AUD$134.00
 Park Regis Griffin Suites
 4.5 Star Rating
 5 minute walk from venue               1 Bedroom Apartment (One Queen bed)                                                       AUD$149.00
 604 St Kilda Rd, Melbourne
                                        2 Bedroom Apartment (Two Queen beds)                                                      AUD$209.00

 NB: if greater occupancy per room is required than stated above, additional fees may apply. Please forward written requests to the conference
 office. Refer to the Accommodation section at http://www.lymphology.asn.au/ for full details.


 Arrival Date: ____ /____ /2010                                Arrival Time (check in 3.00pm onwards):
 Departure Date: ____ /____ /2010 (check out approximately 10:00am)

 Early/Late Arrival: Most hotels allow you to check in from 3pm. If you wish to check in earlier, additional charges may apply. Depending on
 requested check in time prior to 3pm an additional day’s charge may apply. Please indicate here if you wish to check in prior to 3pm.

 I wish to check in at ____ /____ /____ at ______ hours.
 If you will be arriving after 6pm, please notify the Conference Office. Failure to advise late arrival may result in your room being released.

 Accommodation Requirements

 Any Special Requirements

 I have arranged to share with

    No I do not need accommodation booked for me, as I have made other accommodation arrangements.

 I am staying at                                         (name of hotel)                   Friends/Family                      Live locally

 Accommodation bookings must be secured by minimum payment of one night’s tariff. To secure a hotel accommodation booking, a deposit of
 one night’s tariff is required, which must accompany the registration form. Upon check out of the hotel, delegates must settle the balance of their
 account. The deposit for the first night is non refundable if the reservation is cancelled on or after 26 April 2010 or if you do not arrive on the date
 specified on your booking. Rates listed are per room per night and include GST.

 The rates per room per night are inclusive of GST. However, the GST will be on charged by the hotel, as we will forward this deposit to the hotel
 on your behalf. Room rates do not include breakfast unless otherwise stated

 Change of booking
 Changes to bookings must be forwarded in writing to the Conference Office, not directly to the hotel.

 Refund/Cancellation
 Cancellations must be received by 26 April 2010. Otherwise the accommodation deposit will be forfeited in all instances.




 ALA 8th Biennial Conference, 27 – 29 May 2010, Melbourne Australia
Payment Summary
All payments must be made in Australian Dollars only and must include the GST component. Charges paid by credit card will appear as
“Think Business Events Pty Ltd” on your credit card statement.

Please transfer all sub totals from the sections above and check your calculations carefully.


 Conference Registration                                                                                   AUD$


 Book of Proceedings                                                                                       AUD$


 Welcome Reception                                                                                         AUD$


 Breakfast Session                                                                                         AUD$


 Conference Dinner                                                                                         AUD$


 Accommodation                                                                                             AUD$

                                                                                                TOTAL      AUD$


Method of Payment

   Cheque           Bank Draft (Cheques/bank drafts payable in AUD$ to “Think Business Events - ALA”)

Credit Card:       MasterCard                Visa           American Express                Diners

Cardholder’s Name:


Expiry Date:                    /
Card No:

Signature: ____________________________________________________________________________
All amounts in this brochure are in Australian dollars (AUD$) and include 10% Goods and Services Tax (GST).
Privacy Statement
ALA 8th Biennial Conference (the conference) is bound by, and committed to supporting, the National Privacy Principles (NPPs) set out in the
Privacy Amendment (Private Sector) Act 2000.
The Conference will collect and store information you provide in this Registration Form for the purposes of enabling us to register your attendance
at the Conference, to assist with administrative and planning purposes and for future planning and development of the Conference and other
events, to facilitate your requirements in relation to the Conference and to allow the compilation and analysis of statistics relevant to the
Conference.
The information that you provide in the Registration form and information provided at any other time during the Conference, including without
limitation any feedback obtained during the Conference, will be used by the Conference to offer, provide and continue to improve its Conferences
and other services. The Conference may disclose some of the information that is collected in the Registration Form such as your name,
organisation and its location and your email address to other Conference delegates and (unless you object in writing to us) to Conference
sponsors and exhibitors for marketing purposes.
The Conference will not otherwise, without your consent, use or disclose your personal information for any purpose unless it would reasonably be
expected that such purpose is related to the offer, provision and improvement of the Conference or where such purpose is permitted or required
by law.
Cancellation Statement
Cancellations received in writing at the Conference Office by 26 April 2010 will be accepted and all fees refunded less an administrative fee of
AUD$100. Cancellations received after this date cannot be accepted and will not be refunded, however transfer of your registration to another
person is acceptable. The full name and details of the person that will replace you must be advised in writing to the Conference Office prior to the
Conference. No refunds will be made for non-attendance at the Conference.

Please complete and return this form to:                       ALA 8th Biennial Conference
                                                               Conference Office - Think Business Events
                                                               Suite 6, 19-23 Hoddle Street
                                                               Richmond VIC 3121
                                                               Fax: +61 3 8610 2170

If you require additional information contact:                 Website: http://www.lymphology.asn.au/
                                                               Conference Office - Think Business Events
                                                               Ph: +61 3 9417 1350
                                                               Fax: +61 3 8610 2170
                                                               Email: ALA@thinkbusinessevents.com.au




ALA 8th Biennial Conference, 27 – 29 May 2010, Melbourne Australia

				
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