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| REGISTRATION FORM/TAX INVOICE | |||||||||
| CSIRO, ABN: 41687119230 This document will become a Tax Invoice for GST purposes on receipt of your payment. Please keep a copy of the completed form for your records |
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| DELEGATE INFORMATION *Denotes Required Field | |||||||||
| First Name:*………………………………………............................ Title:(Mr, Mrs, Ms, Prof, Dr, Other)*……………….... | |||||||||
| Family/Last Name*……………………………………………………………………………………………………………………….. | |||||||||
| Organisation:*..…………………………………………………………………………………………………………………………….. | |||||||||
| Professional Position:……………………………………………………………………………………………………………………. | |||||||||
| Delegate Postal Address: | |||||||||
| Number and Street (or Post Office Box):*………….………………………………………………………………………………..... |
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| Suburb,Town or City: *…………………………………….…….. Postal/Zip Code: *……………………………………........ |
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| State:*…………………………………………………………………….. Country:*…………………………………………………........ |
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| Email:*…………………………………………………………………………………………………………………………………………............. | |||||||||
| Telephone: Country Code:……………...... Area Code:……….... Telephone Number:……………………………………… |
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| Name you would like to appear on your name badge: (e.g. Dr John Lowenthal)* ……………………………………………………………………………………………………………………………………………………….. |
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| Special requirements: dietary (i.e. vegetarian), visual, audio, mobility (i.e. wheelchair), other. Please describe: ……………………………………………………………………………………………………………………………………………………… |
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| In the event of an emergency (i.e. illness) please provide contact details (name, address, telephone) of a person/organisation who you consent to be notified: ……………………………………………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………………………………………… |
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| A. REGISTRATION FEES | |||||||||
| See NOTES section below for explanation of fee inclusions Registration fee (fee includes GST) |
AUD$ $880 |
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| I will be attending (please tick): | |||||||||
| Day 1 of Conference (Thursday, 20 November 2008) ...................................................... | |||||||||
| Day 2 of Conference (Friday morning, 21 November 2008) ............................................... | |||||||||
| Conference Dinner (Thursday, 20 November 2008) ........................................................ | |||||||||
| Site Visit CSIRO Energy Centre, Newcastle (Friday afternoon, 21 November 2008).............. | |||||||||
| PAYMENT METHODS | |||||||||
| We recommend and prefer Electronic Funds Transfer (EFT) payment, however will accept Bank Draft, Visa or Mastercard credit card. All payments must be in Australian Dollars. We cannot accept cheques, Diners or American Express credit cards. CSIRO staff may also opt for payment via WBS transfer. | |||||||||
| I wish to pay by: (please circle) EFT / Bank Transfer / Credit Card / WBS Transfer | |||||||||
| Bank Transfer and EFT | |||||||||
| Made to: | |||||||||
| CSIRO Bank: Westpac Banking Corporation Branch: Petrie Plaza, Canberra, ACT Australia BSB: 032-719 Account Number: 226787 Account Name: CSIRO. Swift Address: WPACAU2S. |
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| Please quote CSIRO reference number 7001095 and enter your transaction number (if applicable) for validation. |
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| CSIRO Reference Number: 7001095 Your Transaction Number: ________________ | |||||||||
| Credit Card | |||||||||
| I authorise CSIRO to debit $_______from my: VISA Card / Mastercard (please circle) | |||||||||
| Credit Card Number:__________________________________________ Expiry Date:______________ | |||||||||
| Name on Card:______________________________________ Signature:_________________________ | |||||||||
| WBS Number | |||||||||
| CSIRO Staff Only: R-00072-06-002 | |||||||||
| Tick if you require a receipt for your payment (Receipt will be posted to the delegate address listed on this form) | |||||||||
| Fax, post or email this form together with your payment details to: Lisa Ochs, Email: lisa.ochs@csiro.au Fax: +61-2-9490 8212 Postal Address: CSIRO Energy Transformed Flagship, 11 Julius Avenue, North Ryde, NSW, 2113 AUSTRALIA |
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| CANCELLATION AND REFUND POLICY | |||||||||
| Only written (email, fax, postal) advice of registration cancellations will be considered. Cancellations before 31 October 2008 will receive a full refund less A$100 administration fee. Cancellations received after 31 October 2008 will receive no refund of registration fees. Delegate substitutions are welcome up to 17 November 2008 and must be advised in writing, including full details of the substituted delegate. | |||||||||
| I understand and accept the conditions of this cancellation and refund policy | |||||||||
| Signature:...........................................................................Date:............................................ | |||||||||
| NOTES |
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| REGISTRATION INFORMATION | |||||||||
| Registration includes access to all sessions for the 1 1/2 days of the conference, the
conference dinner on 20th November and the site visit to the Energy Centre in Newcastle on
21st November. Morning/afternoon teas and lunches will be provided for the duration of the
conference. All registrants will receive a copy of the conference abstracts. |
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| Accommodation | |||||||||
Should you require accommodation, a special rate of $239 per night has been negotiated for your convenience at the conference venue, the Rydges World Square, 389 Pitt Street, Sydney. Please make any bookings, requests or enquiries directly to the hotel reservations desk by telephone (+61 2 8268 1888). Please indicate that you are attending the Decentralised Energy Technology, Policy and Opportunities for Australia and the Asia-Pacific Region in order to secure our special negotiated rate. |
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Visa / Electronic Travel Authority (ETA) |
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Overseas delegates must obtain a valid Visa or ETA for entrance to Australia. |
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Tick if you require an invitation letter for your visa application |
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ENTRANCE TO CONFERENCE AND SOCIAL EVENTS |
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| Each delegate at the conference will receive a name badge on registration. The badge will be
your official pass and must be worn to obtain entry to all sessions and social functions. |
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INSURANCE AND WAIVER OF LIABILITY |
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WADE, the CSIRO, the CSIRO Centre for Distributed Energy and Power or any of the supporting organisations accept no liability to any persons or body for any loss, injury or damage howsoever and whether directly or indirectly from any action or cause whatsoever undertaken, organised, sponsored or associated with this conference. Registration fees do not include insurance of any kind. It is strongly recommended that at the time you register for the conference and book your travel you take out an insurance policy of your choice. The policy should include loss of fees/deposit through cancellation of your participation in the conference, or through cancellation of the conference, loss of international/domestic air fares through cancellation for any reason, loss of tour monies through cancellation for any reason including airline or related services strikes within Australia, failure to utilise tours or pre booked arrangements due to airline delay, force majeure or any other reason, medical expenses (including sickness and accident cover), loss or damage to personal property, additional expenses and repatriation should travel arrangements have to be altered. The conference managers cannot take any responsibility for any participant failing to arrange their own insurance. This insurance is to be purchased in your country of origin. |
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