A House, My Home, Our Community 6th Practice Talking Conference, 2014 25 November 2014 Registration Package The 2014 Practice Talking Conference will be held on 25 November, 2014 at the Australian Catholic University (ACU), 223 Antill Street Watson ACT. Registration for the Conference is $60.00 for full registration and $30.00 for students and holders of Commonwealth concession cards. Registrations will close on 12 November or when places are filled. Registration includes: • • • • admission to conference; coffee and tea all day; morning and afternoon tea; and lunch Places will be accepted on a first come first serve basis and are limited by available space. If you wish to register a large number of staff please email Natalie Collins at the ACU at Natalie.collins@acu.edu.au To register please complete the registration form below. Remember, registrations close on Wednesday 12 November 2014. Notes: * If paying by credit card please print, sign and fax/mail/scan and email to address above. * Cancellations: If you find you are unable to attend the conference after submitting a registration form and payment, you may nominate a substitute from your own agency. Please contact Reception at ACU on (02) 6209 1100 to discuss. Page 2 of 2 Practice Talking 2014 Conference Registration Form This completed form is accepted by the ATO as a tax invoice, for the purposes of GST, once payment is received. Therefore, this registration form is your receipt so please ensure that you make a copy. Your registration will be confirmed by email. Title (Prof/Dr/Mr/Ms/Miss): Given Name: Surname: Preferred name on badge: Organisation: Postal Address: Emergency Contact name: : Emergency Phone number: : Phone: Email: Dietary requirements/food allergies : Payment Options: (Please check the appropriate box for method of payment) Credit Card Cheque Cash in person By phone For Credit Card payments please complete below: Card Type: Visa Mastercard Card Number: Expiry: CCV Name Shown on Card: Ref: Practice Talking Conference Participant Full price: $60.00 *Signature: _______________________________ Note: Additional Presenters use box below. Please indicate full cost/concession and number of additional presenters Student/Concession : $30.00 Presenters 1st Presenter (free) Additional Presenters full cost: $60.00 X Additional Presenters concession: $30.00 X EFTPOS: Please Contact Reception at the ACU on (02) 6209 1100 to discuss payment via EFTPOS. Bank Transfer: Unfortunately Online Banking funds transfer is not accepted. Post to: Australian Catholic University PO Box 256 DICKSON ACT 2602 Email to: natalie.collins@acu.edu.au Phone: (02) 6209 1100 Fax: (02) 6209 1215 Or deliver in person to: Australian Catholic University, 127 Phillip Avenue, WATSON ACT * ACU ABN: 15050192660 Page 2 of 2
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