Credit Card Form Agreement by ldv16877

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									Credit Card Payment Agreement Form
                                         Authorization Agreement
I hereby authorize Standards Australia to debit my credit card (name below) for the following event(s) that I’ve

registered for and indicated as attending by   ×:

 Status                   Attending                        Event                       Debit credit card

                                                WatersEdge, Social Event for
                                                  Metadata Open Forum
                                                 Wednesday 21 May 2008
                                                       6pm onwards
                                       Only $AUD 80 per person - a 3 course
 Open invitation               ×       dinner menu, including red & white wine,
                                       beer, soft drinks and yes a DJ…
                                                                                       $AUD 80.00

                                       Great venue, directly under the Sydney
                                       Harbour bridge on the water
                                       http://www.harbourbridge.com.au/


                                                                               Total   $AUD 80.00


                                               Account Information
Type of Credit Card
(Amex / Visa / MasterCard)

Credit Card Number

Expiry Date

Full Name as listed on Card

Company Name
(A tax invoice will be sent)

Company Address

Phone & fax Numbers

Email contact

                                                    Signature

Authorized Signature                                                                         Date:



Attendees:
   EMAIL COMPLETED FORM TO Michael.langdon@standards.org.au

								
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