Your Details

First name:

Last name:

E-mail: (Where possible, correspondence will be sent by email)

Organisation:
(if applicable)

Contact Details for Correspondence

Number and Street or Post Office Box:

Town:

State:

  Postcode:

Day time Phone:

  

Day time Fax:

Special dietary requirements or other needs:

Are you a VALBEC Member?

Disclaimer

The VALBEC conference provides a valuable forum for discussion and debate, implicit in which is the understanding that none of the content of the forum is formally endorsed by VALBEC.

 

Conditions and Cancellations

1. Fees includes morning tea and lunch.

2. Registrations cannot be accepted without payment or purchase order.

3. The program is subject to change without notice.

4. All registrations received by the due date will be acknowledged by email (preferred), fax or post.

5. Cancellations prior to September 21, 2007 will incur an administration fee of 20% (including GST)

6. After September 21, 2007, a cancellation fee of $50% (including GST) will apply

7. Payment must be received prior to attending the forum. An invoice or receipt for the items and amounts selected will be sent to the email address provided.

Payments:

I will provide a Purchase Order No. (if applicable)

I will make a direct payment into the VALBEC bank account
(Westpac Melbourne BSB 733-549 Account 56 0644 "VALBEC").

You must provide a remittance advice of payment details so it can be correctly attributed.

I will pay by Visa or MasterCard (phone or mail)

I will send a cheque payable to ‘VALBEC’

 

Fee (includes 10% GST)

Individual member rate

No charge

Organisation member rate

$33

Standard (non-member) rate

$55

 

And finally ...    or start again