Registration Form - University of South Australia

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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
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Expiry date
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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.
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