ABN 83 006 967 817
QUEENSLAND DIVISION
OPTIONS: A) PRINT THE FORM. COMPLETE & FAX B) COMPLETE THE FORM IN ADOBE READER, CLICKING/ OR TABBING EACH FIELD & ENTERING YOUR DETAILS (DO NOT SAVE) PRINT THE FORM & FAX C) COMPLETE THE FORM, ATTACH YOUR CHEQUE & POST TO HEAD OFFICE.
FUNCTION BOOKING FORM
PLEASE PRINT CLEARLY
SECTION ONE
ATTENTION WCEI MEMBERS & GUESTS
You are invited to attend the following WCEI Queensland Division Function:
FUNCTION TITLE: FUNCTION VENUE: GUEST SPEAKERS:
Print Form
Reset Form
FUNCTION CODE: QLD090709 FUNCTION DATE: 9July 2009 FUNCTION TIME: 6.00pm - 8.00pm
WCEI QLD "Reception & Profiling "Slow Food Library Gastronomy"
John Oxley Library
Hosted by Roz MacAllan, Liaison Officer of the Slow Food Library of Gastronomy, owner of Taste Travel
FUNCTION ADDRESS: 4th Floor, State Library Queensland, Southbank COMMENTS: VENUE CONTACT: DRESS CODE: COST: MEMBER FEE (Inc GST): COMMENTS: RSVP: RSVP DATE:
Parking is available under the Library
VENUE TELEPHONE NO:
$55.00
GUEST FEE (Inc GST):
$77.00
Please Book Early as numbers are limited.
Thursday 2 July 2009
RSVP TO: Andrea Palmer, Cable Laying Products
EMAIL ADDRESS: clp@cablelaying.com.au TELEPHONE NO: 07 3276 7166 FACSIMILE NO:
07 3276 7199
SECTION TWO
Please complete this section.
WCEI MEMBERSHIP NUMBER IF KNOWN: TELEPHONE NUMBER:
MEMBER'S FULL NAME: EMAIL ADDRESS: NUMBER OF MEMBERS ATTENDING: NUMBER OF GUESTS ATTENDING:
Please advise full names of those attending:
MEMBER NO 1: GUEST NO 1: MEMBER NO 2: GUEST NO 2:
SECTION THREE
METHOD OF PAYMENT:
TOTAL NO. OF MEMBERS ATTENDING: TOTAL NO. OF GUESTS ATTENDING:
X X
EVENT FEE: $55.00 EVENT FEE: $77.00
= =
SUB TOTAL: SUB TOTAL: TOTAL:
WCEI PAYMENT OPTIONS: Please tick your preferred option of payment:
OPTION 1
Account Name: Bank: BSB Number:
Electronic Funds Transfer Womens Chiefs of Enterprises Westpac Bank 034-002 Account Number: 788028
TOTAL EFT: Please quote your SURNAME and FUNCTION CODE as your Reference on your EFT to ensure your payment is allocated correctly eg Parker QLD020909 - Please refer to the top right hand corner of Page One for the Function Code. If the online field is too small, please quote the function Code only and advise WCEI of your EFT Payment.
SURNAME / FUNCTION CODE:
OPTION 2
Card Type: Card Number:
CARDHOLDER'S NAME:
Credit Card Expiry Date:
TOTAL AMOUNT:
CARDHOLDER'S SIGNATURE:
I hereby authorise WCEI to charge my credit card the amount shown above as function payment.
When complete, please fax Booking Form to 07 3276 7199
OPTION 3
Postal Address:
Cheque / Money Order WCEI National Head Office, PO Box 340, Carole Park, Brisbane Qld 4300
Please make cheque payable to Women Chiefs of Enterprises International
COMMENTS:
This is a Tax Invoice once payment has been made. Women Chiefs of Enterprise International ABN 83 006 967 817
For all payment enquiries, please contact: Andrea Palmer Email: clp@cablelaying.com.au Telephone: 07 3276 7166 Facsimile: 07 3276 7199
SECTION FOUR OFFICE USE ONLY
DATE PROCESSED: PAYMENT METHOD: CREDIT CARD VERIFICATION NB AMOUNT PAID: CARD TYPE: INVOICE NUMBER:
SIGNATURE OF OFFICE MANAGER: