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					                            ACIS Sixth Biennial Conference
                          Melbourne University 13-16 July 2011

                                   Conference Registration
                                       (Tax invoice for GST)


Personal Details

Title ___________ Name _____________________________________________________

Position title _________________________________________________________________

Organisation _________________________________________________________________

Postal address _______________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

Telephone __________________________________________________________________

Email ______________________________________________________________________


Please advise if you have any dietary requirements:                      vegetarian meals
Other, please indicate: _________________________________________________________



An innovative aspect of the conference will involve the integrated use of mobile technology. We
encourage you to bring your own personal equipment. For this reason, could you please indicate
whether you intend to bring with you

 iPad          iPhone              iPod Touch           Laptop/Netbook
 Other Smartphone (e.g. Blackberry, Google Android, Nokia E72, etc.) – please indicate ………………
 none of the above
Registration Fees
Fees are in AUD$ and are inclusive of GST. Registration cost includes tea breaks and lunches.

           13-16 July Conference Registration                                             Fees                       Amount
Early bird Registration (closes 1 February, 2011)                                                 $390           $
Full Registration (after 1 February, 2011)                                                        $420           $
Postgraduate Registration                                                                         $210           $
                Single day Registration
Single day Registration                                                                           $160           $
Single day Registration – postgraduate                                                              $80          $
                       Optional
Conference dinner (15 July 2011)                                                                    $95          $
Conference dinner – additional guest(s)                                                             $95          $
                                                                            Total cost (incl. GST):              $

Payment authorisation (please indicate method of payment)

    Credit card

Card type:        Visa                 Mastercard

Card number: _ _ _ _ / _ _ _ _ / _ _ _ _ / _ _ _ _                             Expiry Date: _____________

Cardholder’s name ______________________________ Total amount AUD$________

Cardholder’s signature ___________________________________ Date ____________

Cardholder’s email address _________________________________________________


    Cheque enclosed (Please make payment payable to The University of Melbourne)

Registration forms should be sent by post or email to:
Elisabetta Ferrari
School of Languages and Linguistics
Babel Building, room 311
The University of Melbourne
Parkville, 3010
Victoria, Australia

Email: eferrari@unimelb.edu.au

* By registering for this conference you accept that your participation may be recorded (audio and/or video) for distribution over the
Internet. For more information, please contact Elisabetta Ferrari: eferrari@unimelb.edu.au




For office use only
Account charging: _ _ / _ _ _ / _ _ / _ _ _ _ _ / _ _ _ / _ _ / _ _
Date:

				
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