| Company Name |
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| Delegate Name |
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| Delegate Position |
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| Delegate Phone Number |
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| Delegate Email Address |
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| Billing Company/Contact |
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| Billing Address |
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| Country |
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| Region/State |
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| Postcode |
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Billing Contact Name
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Same as Delegate Name
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| Billing Contact Phone |
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| Billing Contact Email |
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| Registration Rate |
$A950 (inc of GST) before 13 August 2009.
$A1,050 (inc of GST) after 13 August 2009. |
Payment methods
Please check one |
Cheque
Payable to Paydirt Media Pty Ltd and marked "not negotiable"
Credit Card
Please note that a merchant fee of 3.8% applies to payments made on Amex and Diners cards.
Please call (+61 8) 9321 0355 to pay by credit card over the phone or
complete this form and fax back with your credit card details.
Bank Transfer/EFT
(please quote invoice number or company name)
PAYDIRT MEDIA PTY LTD Bank: ANZ Bank, West Perth Account: 837162319 BSB: 016-498
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| For enquiries please contact |
Jade Riolo, P.O.Box 1589, West Perth, Western Australia 6872
Tel: (+61 8) 9321 0355
Fax: (+61 8) 9321 0426
Email: jade@paydirt.com.au |
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CONTRACT
• To take advantage of our early bird rate of $A950 (including GST), please register and pay by Friday 13th August 2010. If payment is not received by that date, the rate will automatically revert to our normal delegate rate of $A1,050 (inc GST).
• Normal delegate registration payment is due and payable on Friday 10 September 2010. No refunds/credits will be given for cancellations made after this date. However, replacement/ substitute delegates may be nominated.
• Cancellation/substitution requests must be submitted in writing to the conference coordinator prior to the conference.
• As the event is held and hence deemed to be enjoyed in Australia, delegate fees are subject to the Goods and Services Tax (GST).
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