A House, My Home, Our Community 6 Talking

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
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 [email protected]
To register please complete the registration form below.
Remember, registrations close on Wednesday 12 November 2014.
* 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.
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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:
Preferred name on badge:
Postal Address:
Emergency Contact name: :
Emergency Phone number: :
Dietary requirements/food allergies :
Payment Options: (Please check the appropriate box for method of payment)
Credit Card
Cash in person
By phone
For Credit Card payments please complete below:
Card Type:
Card Number:
Name Shown on Card:
Ref: Practice Talking Conference
Full price:
*Signature: _______________________________
Note: Additional Presenters use box below.
Please indicate full cost/concession and
number of additional presenters
Student/Concession : $30.00
1st Presenter (free)
Additional Presenters full cost:
Additional Presenters concession:
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
Email to:
[email protected]
Phone: (02) 6209 1100
Fax: (02) 6209 1215
Or deliver in person to: Australian Catholic University, 127 Phillip Avenue, WATSON ACT
* ACU ABN: 15050192660
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