TIME 2000 Conference Registration Form

Title:	Prof Ass. Prof Dr Mr Mrs Ms
First Name
Family Name
Department/Faculty
Institution
Address
City
Country
Postcode/ZIP Code
Telephone Office:
Telephone Home:
Fax
E-mail

All Fees in $NZ and inclusive of GST

A- Registration:

	By 24 October	After 24 October
Full	$450	$500
Single Day Day   Tuesday Wednesday Thursday	$225	$250
Student Full	$150	$150
Student Single Day Day   Tuesday Wednesday Thursday	$75	$75

Total A:

 

B- Accommodation:

O'Rorke Hall	Railway Campus Standard Studio
Railway Campus Large Studio
Date In:   Sat 09 Dec Sun10 Dec Mon11Dec Tue 12 Dec Wed13 Dec	Date Out:   Tue 12 Dec Wed 13 Dec Thur 14 Dec Fri 15 Dec Sat 16 Dec

Total B:

Prices per night for accommodation:

O'Rorke Hall $59

Railway Campus Standard Studio $77

Railway Campus Large Studio $83

C- Optional Extras (Partners/ Guests, Day/ Student Registrants)

Conference Dinner $65

Conference Reception $25

Must See Three Tour $69........Day   Mon 11 Dec Fri 15 Dec

Gannets & Volcanics of the West $69......Day   Mon 11 Dec Fri 15 Dec

Interested in Tours on other days

Total C:

TOTAL A+B+C:

Less deposit:

TOTAL PAYMENT:

D- Special Interest Group Meetings I Suggest The Following Topic(s)

PAYMENT (inclusive of GST)

Cheque (payable to the University of Auckland)

Please Invoice (New Zealand Only)

Or Debit......... Visa

Mastercard

Please do not send your credit card details via email or the Web

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*All payments in New Zealand Dollars.

Cheques should be made payable to The University of Auckland

Cheque

or DEBIT Visa Mastercard

Account Number

Expiry Date Signature

The Privacy Act 1993 - The Centre for Continuing Education undertakes to collect, use and store the information you provide on this form according to the principles of the New Zealand Privacy Act 1993.

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All bookings subject to receipt of payment

Please forward payment to:

Centre for Continuing Education

The University of Auckland, Private Bag 92 019, Auckland, New Zealand

Fax: 64 9 3737419

Cheques payable to The University of Auckland

Credit Cards: We accept Visa and Mastercard only

Have you printed this form?

Complete the form except for credit card details, print the form, then click the Submit Registration button.

On the printed version add your credit card details and fax or mail it to us.

 

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