Get To Know IBM® SPSS® Amos™ for Structural Equation Modeling 2 This document will become a tax invoice for GST purposes. Please return the form with your payment to Robert van der Veen: robert.vanderveen@unisa.edu.au Workshop Registration Contact details Family Name First Name Organisation Mailing Address Title Postcode Telephone Email *Food preferences intolerances Mobile or Registration Fee: Get To Know IBM® SPSS® Amos™ for Structural Equation Modeling Internal Registration (UniSA student or staff) External Registration (external to UniSA) $ 250.00 inc GST $ 295.00 inc GST The registration fee includes lunch and tea/coffee on both days. Payment options (a) To register using a Personal Development fund or another cost centre account – email (robert.vanderveen@unisa.edu.au) requesting a funds transfer. Please include the cost centre number and obtain cost centre manager’s approval for the transfer. (b) Electronic Funds Transfer Bank Account Details: National Australia Bank King William St, Adelaide SA Uni of SA General Account BSB 085-005 A/C # 516545570 Swift # NATAAU 3305A Please ensure that you quote 'ACAB Workshop' and your name in the payment reference area and send through proof of payment to robert.vanderveen@unisa.edu.au. (c) Payments by credit card Complete this form and forward to Robert van der Veen: robert.vanderveen@unisa.edu.au. Please debit [ ] Visa [ ] Mastercard Amount AUD Card No ___ ___ ___ ___ | ___ ___ ___ ___ | ___ ___ ___ ___ | ___ ___ Expiry date ___ ___ / ___ ___ Cardholder name Cardholder signature Date ___ / ___ / ___ Note For GST Purposes The Australian Business Number (ABN) for the University of South Australia is 37 191 313 308. Please regard this registration form as a workshop offer. No separate invoice will be issued. Upon payment of the appropriate amount this registration from will become a tax invoice. Please keep a copy of this from for taxation purposes.