Bookings

ABN 35 488 356 910

REGISTRATION FORM
32nd ANNUAL SEMINAR

Melbourne University Private
442 Auburn Road, Hawthorn, VIC 3122
[click for map] MELREF: 59E2

23rd October 2010

ONE FORM PER PERSON PLEASE
Please fill out the following order and press "Send Registration".
Your tickets will be despatched together with an invoice
for your return cheque and the amount required.
or
Please complete and return this form with a
STAMPED SELF ADDRESSED ENVELOPE TO:

Secretary - Mr. Robert M Wardzynski
PO Box 416 South Morang, Victoria, Australia 3752
Tel: (03) 9436 8366 Fax: (03) 9436 8377 Mob: 0408 991 307
Email: admin@cessci.com.au

TITLE:
GIVEN NAMES:  SURNAME:
E-MAIL:
ORGANISATION:
ADDRESS:
CITY:  POSTCODE:  STATE:
CONTACT NUMBER (A/H):
CONTACT NUMBER (BUS):
MOBILE NUMBER (MOB):
FAX NUMBER:
REGISTRATION FEES (GST Included)
Please place a tick in the box for your Preference's
One Form Only Per Person
One Day Only Saturday 23rd $60.00

Convivial 1700-1900
Please Mark if you intend to stay
We require this for Catering purposes

Last Update: Thursday 15th April 2010