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Registration Form

By submitting this form you agree to the terms of the cancellation policy.
All prices quoted are in Australian Dollars and are inclusive of GST.   ALGA ABN: 31 008 613 876

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 nga@confco.com.au.

   
This form is for NEW REGISTRATIONS ONLY.  To make an AMENDMENT contact Conference Co-ordinators
   
Personal Details
Please DO NOT type in ALL CAPITALS
 
Position:
Address:
Suburb:  
Phone:   
Email: This email will be used to send your confirmation letter to you and any event updates
Reconfirm Email: Re-enter your email address here to ensure it is correct
Name for Badge: Organisation and State as provided above will also be included on your badge
Special Requirements (e.g Diet, Mobility):
 
Questionnaire
 
At future NGA's would you be interested in using a conference app that would contain information such as program, speakers and exhibitor contacts?
YES NO
How did you find out about the National General Assembly?
ALGA News Registration Brochure   Website ALGA   State/Territory Association  Council 
Other - Please Specify:
 
Privacy Disclosure
 
I consent to my name appearing in the 2019 NGA List of Participants (name, organisation and state only disclosed).
I consent to ALGA disclosing my personal contact information as outlined in the privacy disclosure.
 
Registration Fees
 
National General Assembly Registration Fees (Monday 17 June - Wednesday 19 June)

Total
National General Assembly Concurrent Sessions (Tuesday 18 June)  

PLEASE SELECT the concurrent session that you believe you will attend on the day.

 
 
Business Papers  

Business Papers will be available electronically approximately 2 weeks prior to the event. Note: There will be no hardcopies sent before the conference.

If you would like a hard copy of the business papers when you arrive at the conference, please select below.

 
 
Regional Development Forum Registration Fees (Sunday 16 June)  
Total
DISCOUNT CODE:  
Sub total
   
Accompanying Partners Registration Fees  

 

 
Total
   
Accompanying Partners Details  
Title  First Name  Surname  
Partners Special Requirements eg Diet, Mobility

 

 

State of the Regions Report  - On-line License Purchase
You may purchase either of the following licenses  
Single License:  Single user access to the on-line version $260.00  
Organisational License:   Access to the online version for unlimited number of users within a single council, library, educational institution,government department or organisation $720.00  
Total
Social Functions Included in Fees
   
One ticket to each of the following functions is included in the full National General Assembly Registration and/or accompanying partners' 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.
Registered Delegates and Partners: Welcome Reception, Sunday 16 June  
I/we will attend  Delegate  Partner  Number of Additional Tickets @ $50.00 each Total
Registered Partners Day 1, Monday 17 June: Lake Cruise to Monet
    Partner Number of Tickets @ $125.00 each Total
Registered Partners Day 2, Tuesday 18 June: Pottery and Wine Experience
     Partner Number of Tickets @ $125.00 each Total
   
Optional Social Functions (additional fee applies)
   
Tickets to these functions are not included in the National General Assembly registration fee or accompanying partners' registration fee. To purchase tickets to any of the following functions please indicate the number required.
Networking Dinner at the Australian War Memorial - Monday 17 June
  Number of tickets required @ $110.00 each Total

 

NGA Dinner - Tuesday 18 June **NUMBERS STRICTLY LIMITED**

  Number of tickets required @ $140.00 each Total
   
     
  GRAND TOTAL  
   
Registration and Social Function Payment Details
I am forwarding a cheque made payable to ALGA
Please issue an invoice (Invoices are automatically issued on receipt of registrations)
Please issue and invoice and quote Purchase Order number 
I have transacted an Electronic Funds Transfer to the ALGA Conference Account.  
ALGA Account: Bank: Commonwealth Branch: Woden, ACT BSB No: 062 905 Account No: 10097760. NOTE This account is specifically for conference payments ONLY
Please charge my credit card the total noted above MasterCard VISA
Card Number      Expiry Date
Name of the person who signs the card
NOTE: Credit cards are not automatically charged when you submit this form. Cards are processed within 5 working days of submission.
Accounts Contact
If you would like 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
   
Accommodation
   
If you DO NOT require accommodation proceed to the SUBMIT button at the bottom of the page
   

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 3 May 2019. All cancellations or amendments must be made in writing to Conference Co-ordinators and will be acknowledged by facsimile.

 

All accommodation bookings must be accompainied by a credit card in order to secure your reservation. The credit card will be not charged unless you fail to give 21 days notice in writing of your cancellation. You are required to pay for your full accommodation account and any incidental expenses incured during your stay when checking out of the hotel.

 

If you wish for the hotel to settle the account with a credit card of which the delegate is not a signatory, you must provide written authority to the hotel to do so. Please download the credit card authority autorisation form here, and send it to conference@confco.com.au when you have registered.

   
           
Crowne Plaza Hotel Information          
Superior Room $325 per night   Single Twin Double
Deluxe Room $375 per night   Single Twin Double
Avenue Hotel Hotel Information          
Superior King Room $280 per night   Single Twin Double
1 Bedroom Apartment $330 per night   Single Double  
Waldorf Apartments Hotel Information          
Studio Apartment $210 per night   Single Twin Double
1 Bedroom Apartment $230 per night   Single Twin Double
Adina Apartment Hotel          
1 Bedroom Apartment $225 per night   Single Twin Double
   2 Bedroom Apartment $299 per night   Queen/Queen Queen/2 Singles
Qt Canberra Hotel Information          
Standard Room $249 per night   Single Twin Double
Novotel Hotel Information          
  Standard Room $290 per night   Single Twin Double
  Executive Room $325 per night   Single Twin Double
Mantra on Northbourne Hotel Information          
Hotel Room $240 per night   Single Twin Double
  1 Bedroom Apartment $280 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 Credit Card Guarantee Details
   
Accommodation Booking Details
   
USE date format dd/mm/yyyy  you MUST use the / key
Date of Arrival (dd/mm/yyyy) Date of Departure (dd/mm/yyyy)  
Estimated Time of Arrival Sharing with (if applicable)  
Special Requirements eg Diet, Mobility
   
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 Guarantee Details
   
Please use the credit card details provided above (to pay for my registration) to guarantee my accommodation
Please use the following credit card to guarantee my room MasterCard VISA American Express      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 nga@confco.com.au