REGISTRATION FORM and TAX INVOICE by hcj

VIEWS: 3 PAGES: 1

									        REGISTRATION FORM and TAX INVOICE
                               (The Winding Staircase, ABN 49 109 202 986)




                               August 25-26
                                         Or
                           November 9-10


              Becoming a facilitator of Open Space Technology
 Name:

 Organisation:

 Address:                                                                     Postcode:

 Telephone:                                            Email:

 Any special needs (food/access etc):

 Dates     (please indicate)      Tues-Wed August 25-26          or    November 9-10 (9am–430pm)

 Cost            Corporate         $800 (includes GST) Early Bird $700 before JULY 30 /OCT 15
         Community/Student $600 (includes GST)         Early Bird $500 before JULY 30 /OCT 15


 Payment:           Cheque / Credit Card / Cash / Bank Deposit (Please indicate)
             Cheques payable to The Winding Staircase, PO Box 484, Bentley, WA 6102

     Note: direct electronic bank transfer             Cancellation Policy
     (EFT) may be made to:                             Cancellation within 14 days of programme – refund 70%
                                                       Cancellation within 7 days of workshop – no refund
     National Australia Bank, BSB: 086-006             You are welcome to substitute another participant or
     Account Number: 57-167-9045                       transfer to another program
     (Reference: ‘OST’ and your (initials)


CC DETAILS       – 2% SERVICE CHARGE ADDED WHEN PAYING BY CREDIT CARD (Visa, MasterCard or BankCard).
If paying by credit card, please ensure you include your signature - then either SCAN the registration form
and email to Brendan OR normal mail to Winding Staircase address above.

 NAME ON CARD _____________________                    CARD NUMBER_____________________

 EXP DATE _______ SIGNATURE__________________________                                  DATE______

               Please keep a copy of your Registration Form as your Tax Invoice

								
To top