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Indigenous Stock Exchange

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SEN Conference 2001 Online Registration

Location: Melbourne, Australia
Carlton Crest Hotel 4 - 5 March 2002

Instructions on how to fill out this form.

Taxation Invoice ABN No. 31 095 112 913
SECTION A: Delegate (A separate application form must be completed for each delegate)
Title:	Mr Mrs Ms
Firstname:
Surname:
SEN Member?	Yes No
Organisation Name:
Position Title:
Street Address:
Suburb/Town:
State:	Postcode
Country:
Telephone:	Fax: Mobile:
Email:
Special Requirements (eg. dietary, disability)
SECTION B: Registration Fees (inclusive of GST)
	Early Bird (by 24/12/01)	Standard (After 24.12.01)
SEN Member	$300	$350	$AUD
Non-Member	$350	$395	$AUD
SECTION C: SEN Annual Membership Application Fee
Standard	$ 99		$AUD
Concession/Student	$ 33		$AUD
SECTION D: Members Dinner (inclusive of GST)
Member delegate, (if attending)	$75		$AUD
No. of non-member guests	guests @ $90 each		$AUD
SECTION E: Payment (Please make all cheques payable to SEN)

Payment Section B	Registration Fees	subtotal:	$AUD
Payment Section C	Membership Fee	subtotal:	$AUD
Payment Section D	Members Dinner	subtotal:	$AUD
TOTAL AMOUNT DUE:			$AUD
SECTION F: Credit Card Payment / Direct Credit Transfer
Direct Credit Transfer	Bendigo Bank: BSB No. 633-0000, A/C No. 112 669 429
Credit Card Payment	Visa Mastercard Bankcard (Aust only)
Cardholders Name:
Credit Card Number:
Expiry Date:	mm/yy format, e.g., 09/02
Your Email:	A receipt will be sen-devt to this email address

The BAMA ISX is not a financial market and does not sell or trade financial products of any kind.

© 2004 Indigenous Stock Exchange
This page: http://text.isx.org.au/site/conf_rego_01.html
Last Modified:Wednesday, 09-Aug-2006 11:29:56 EST

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