Registration Form

By submitting this form you agree to the terms of the cancellation policy set out in the conference information brochure.
All prices quoted are in Australian Dollars and are inclusive of GST

The data in this form is not recorded until the SUBMIT button is pushed. The SUBMIT button is at the bottom of this form. NOTE: You will receive a confirmation via email of your registration (which will also be your tax invoice) within seven days from Conference Co-ordinators.  If you do not receive written confirmation please contact Conference Co-ordinators on +61 (0)2 6292 9000 or via email at conference@confco.com.au.

THIS FORM IS FOR NEW REGISTRATIONS ONLY.  TO MAKE AN AMENDMENT CONTACT CONFERENCE CO-ORDINATORS

Personal Details
 
Title First Name Surname
Position
Organisation
Address
Suburb State Postcode
Phone Fax Mobile
Delegates Email

Your confirmation and any updates will be sent here

Reconfirm Email Re-enter your email address to ensure it is correct
Name for Badge Organisation and State as provided will also be included
  Special Requirements eg Diet
Are you under 25?


Privacy Disclosure
I DO consent to my name appearing in the 2010 AAEE List of Participants (name, organisation and state only disclosed).
Abstract Submission
IMPORTANT: This code is to be used by the person who submitted the abstract ONLY, not co-presenters or co-authors. If you have forgotten your abstract code contact Conference Co-ordinators on 02 6292 9000. This code will prevent duplicate registrations.
I have submitted an abstract and I am the contact person

My abstract code as quoted in my confirmation letter is
REMEMBER: This code is to be quoted by the contact person ONLY not co-presenters opr co-authors

 
Registration Fees


AAEE Member registration fees

Late (payment received after 13 August 2010)- $770

Non-Member registration fees
Late (payment received after 13 August 2010)- $850

AAEE Member Full-time Student* or Concession Card Holders** registration fees
Late (payment received after 13 August 2010)- $330

Non-Member Full-time Student* or Concession Card Holders** registration fees
Late (payment received after 13 August 2010)- $380

AAEE Member Day registration fees (per day)
Late (payment received after 13 August 2010)- $220
Indicate which day you will be attending Wednesday Thursday

Non- Member Day registration fees (per day)
Late (payment received after 13 August 2010)- $275
Indicate which day you will be attending Wednesday Thursday

*Student Registration Fees
You must be a full time student to qualify for the student rate.  Your registration form must be submitted with a signed letter confirming your full time student status on your educational institution’s letterhead by your lecturer or student administrator.

**Concession Card Holders
Please provide you card number in special requirements above.

-Registration Sub-Total
Mentoring Program View Mentoring Program Information
I am interested in becoming
To assist us match up Mentors and Mentees, please provide some keywords that best describe your areas of interest
Social Function Fees
Welcome Reception, Sunday 26 September 2010
One ticket to the welcome reception is included in the full registration fee, please confirm if you will be attending by selecting the appropriate boxes. To purchase additional tickets to any of the functions please indicate the number required.
I WILL ATTEND DelegateNumber of Additional Tickets @ $45.00 eachTotal
Conference Dinner, Wednesday 29 September
To purchase tickets to the conference dinner please indicate the number required.
-Number of Tickets required   @ $110.00 each-Total
-GRAND TOTAL
Field Trip Selection View Field Trips
A Field Trip on Tuesday Afternoon is included in a Full Registration or Tuesay Day Registration.  Numbers are limited,on some trips, please select your first preference but also indicate your second preference, should your first choice not be available.
First Preference
Second Preference
Registration and Social Function Payment
I am forwarding a cheque made payable to Conference Co-ordinators - AAEE Conference            
Please issue an invoice (Invoices are automatically issued on receipt of registrations)
Please charge my credit card the total noted above Expiry Date
Card Number Card Signatories Name

NOTE: Credit cards are not automatically charged when you submit this form. Cards are processed within 5 working days of submission.

Accounts Contact

To have a copy of your invoice sent directly to your accounts section please provide an email and contact name below.
Accounts Contact: Title
First Name Surname

Accounts Email
IF YOU DO NOT REQUIRE ACCOMMODATION
PROCEED TO THE SUBMIT BUTTON AT THE BOTTOM OF THE PAGE
Accommodation

-
To book your accommodation at the rates listed below complete this section of the registration form.

Bookings are subject to availability and should be made prior to Friday 27 August 2010.  All cancellations or amendments must be made in writing to Conference Co-ordinators and will be acknowledged by facsimile.  Please note your credit card details are required to guarantee your room. Neither Conference Co‑ordinators nor the hotel will make any charges against your credit card unless you fail to give 21 days notice in writing of your cancellation. Full payment of your account will be required at the time of your departure.

-
Rydges Lakeside Hotel
STANDARD ROOM $208 per night
Novotel Canberra Hotel Information
STANDARD ROOM
Mantra Canberra Hotel Information
HOTEL ROOM -$222 per night Single Twin Double
$262 per night Single Twin Double
Canberra Rex Hotel Hotel Information
STANDARD ROOM $177 per night Twin (Includes Brereakfast for 2)
STANDARD ROOM (Includes Brereakfast for 2)
Marque Hotel Hotel Information
STANDARD ROOM $170 per night Single Twin Double
Please indicate your second and third choices of accommodation below should your first choice not be available.
2nd Choice
3rd Choice
Accommodation Reservation Details
Date of Arrival (dd/mm/yy)Date of Departure (dd/mm/yy)
Estimated Time of Arrival Sharing with (if applicable)
Special Requirements

I understand that neither Conference Co-ordinators or the hotel will make any charges against my card unless I fail to give at least 21 days notice in writing of my cancellation.  Cancellations or reductions to your booking made less than 21 days prior to your arrival will require payment in full unless the room(s) can be resold.  Full payment of the account will be required at the time of departure.

 
Accommodation Credit Card Details
Please use the credit card details provided above (to pay for my registration) to guarantee my accommodation
-Expiry
Card Number    Card Signatories Name
 
Cancellation Policy
I understand that by submitting this registration form I agree to the terms of the cancellation policy. Click here to view the cancellation policy.

If your submission is successful a page will display
that thanks you for your registration and provides
further details. If the Thank-you page does not
display
contact Conference Co-ordinators
on +61 2 6292 9000 or email conference@confco.com.au