ANU COLLEGE OF ARTS & SOCIAL SCIENCES Research School of Humanities and the Arts Conference In the Image of Asia: Moving across and between locations 13-15 April 2010 Venue: Sir Roland Wilson Building, The Australian National University Conference Registration Form and Tax Invoice THE CONFERENCE IS OPEN TO ALL ON PAYMENT OF REGISTRATION FEE To register for the conference, please print out this form, fill in the details, and send to the address below, with your payment. Your receipt will be issued on arrival at the conference. For more information about the conference please -visit: http://rsh.anu.edu.au/events/2010/imageofasia/index.php Attendee Information & contact details: Title: Mailing Address: First Name: Surname: Department: State/Province: Country: Postal/Zip Code: Institution: Email: Telephone: Registration fees Registration covers morning and afternoon teas and Early bird Regular lunches. All fees are inclusive of GST. The Australian National University — ABN 52 234 063 906 (by 21 December 2009) (by 10 March 2010) Standard $210 $250 Concessions/Students $120 $160 Standard Day Rate $80 $90 Concessions/Students Day Rate $50 $60 For Day Rate please circle day of attendance: Tuesday Wednesday Thursday $40 Conference dinner (optional) Please circle Vegetarian or non-V TOTAL Payment Cheque (AUD$) The Australian National Payable to: University Post, Email or Fax this form with your Cash: payment to this address: Credit Card: Leena Messina, Programs Manager Visa Research School of Humanities College of Arts & Social Sciences Mastercard The Australian National University Sir Roland Wilson Building #120 Bankcard Canberra ACT, Australia Card Number: T: + 61 (0)2 612 54357 Expiry Date: F: + 61 (0)2 612 51380 E:Leena.Messina@anu.edu.au Cardholders Name: Cancellation will incur a $20 administrative fee. Please tick the box if you wish to go on the RSH mailing list to receive information about up- coming conferences.
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