Registration Form
This form constitutes a Tax Invoice and can be used for tax purposes. Please fill out ONE registration form PER PERSON attending
TAX INVOICE / RECEIPT
ABN: 153 615 641 02
All Registrations close 23rd October 2015
Earlybird registrations close 31st August 2015
Please note that all fields must be filled in
Title
Surname
Given Name
Organisation
Address
City/Suburb
State
Telephone
Mobile
Postcode
Email
Do you have any special dietary requirements?
No / Yes (please list):
Do you require wheelchair access?
No / Yes
Are there any other requirements that we should be made aware of? No / Yes (please list):
Please indicate/circle which event(s) you wish to attend:
For all student/concession prices, a photocopy of the student/concession ID is required, otherwise full price will be
charged
Event
Corporate
Government
(incl. GST)
(incl. GST)
Schools /
Universities /
Training
provider
Community
Stude
(incl. GST)
(incl. G
(incl. GST)
1 Day (incl. opening ceremony Tues 10th Nov)
Select: Wed 11th or Thurs 12th or Fri 13th
3 Days (incl. opening ceremony Tues 10th Nov)
Earlybird Package (Opening ceremony + 3 days + Gala
Dinner – register before 11.59pm EST on 31st Aug)
Full Package (Opening ceremony + 3 days + Gala
Dinner – 1st Sept onwards)
Gala Dinner Only (excl. opening ceremony Tues 10th
Nov)
Extras
Myki Pass - includes unlimited travel across
Melbourne public transport (zones 1+2) for the week
of the conference (Tues 10th – Mon 16th Nov)
$515.00
$455.00
$430.00
$285.00
$230
$1470.00
$1300.00
$1160.00
$730.00
$585
$1540.00
$1380.00
$1180.00
$750.00
$625
$1620.00
$1450.00
$1310.00
$880.00
$73
$150.00
$150.00
$150.00
$150.00
$150
$45.00
$45.00
$45.00
$45.00
$45.
Grand Total: $
Payment: Credit Card, EFT, Cheque
Credit Card
Mastercard
VISA
Or call 1300 663 450 to arrange payment
Card number
Expiry
Name on card
CCV
EFT
Cheques
Bank Commonwealth Bank
BSB 063 147
Account number 1029 7349
Please make cheques payable to Fruitbowl Productions
Terms and Conditions
By registering for this conference, ‘You’ agree that the above details You have provided for the National Aboriginal and Torres Strait Islander
Education Conference (NATSIEC) 2015 may be disclosed to the conference venue and accommodation providers and suppliers (for the purpose of
room bookings and catering needs). You also agree for VAEAI to use Your personal information for the purposes of conference registration, to
market the conference and for related, internal management purposes.
By registering as a delegate, You agree that the Victorian Aboriginal Education Association Incorporated (VAEAI) will not be liable for any:
- Personal injury to You; or
- Loss of or damage to Your property in connection with the event, except to the extent that any unlawful, willfully wrongful or negligent act or
omission of VAEAI, caused or contributed to the loss, damage, expense, or liability.
Please complete form and return to PO Box 1391 Kensington 3031, Fax to 1300 067 748 or e-mail to
natsiec2015@vaeai.org.au