Tutorial Day 2nd December 2014 and SST Conference 3rd – 5th December 2014
REGISTRATION FORM
PLEASE COMPLETE AND EMAIL TO nzilbb@canterbury.ac.nz
TITLE
FIRST NAME
SURNAME
AFFILIATION
EMAIL
Registration includes:
 Tutorial Day – attendance at workshops, morning tea and afternoon tea.
 Conference - Morning tea, lunch, afternoon tea.
 Conference dinner includes transport to and from the venue.
REGISTRATION FEES (all in NZD)
Registrant
Early
ASSTA MEMBER FACULTY
$520
NON ASSTA MEMBER FACULTY
ASSTA STUDENT MEMBER
NON ASSTA STUDENT MEMBER
□
$560 □
$300 □
$340 □
Regular
□
$590 □
$330 □
$370 □
$550
http://www.nzilbb.canterbury.ac.nz/SST.shtml
nzilbb@canterbury.ac.nz
Are you attending the Tutorial Day on 2nd December?
YES
□
NO
□
Please tick which sessions you will be attending:
SESSION ONE
9.30am – 12.30pm
Dr Donald Derrick
Ultrasound for Speech
SESSION TWO
9.30am – 12.30pm
Dr Chigusa Kurumada
Perception and Interpretation of Speech Prosody


SESSION THREE
2.00pm – 5.00pm
Associate Professor T. Florian Jaeger
Regression and Mixed Effects Models

Are you attending the conference dinner at Willowbank Wildlife Reserve on 4th December ?
YES
□
NO
□
Would you like to add a partner to attend the conference dinner - $108 NZD
YES
What is their name: ______________________________________________________
If you have any special dietary requirements please advise here:
TOTAL TO PAY
Registration amount
$
Extra person for conference dinner
$
TOTAL
$
http://www.nzilbb.canterbury.ac.nz/SST.shtml
nzilbb@canterbury.ac.nz
□
OPTIONS FOR PAYMENT
Please tick which option you will be paying by
CREDIT CARD

Payments are accepted from Visa and Mastercard and will be billed in NZD.
Visa

Name on card
_______________________________________
Signature
_______________________________________
Card number
_______________________________________
Expiry
__ / __
DIRECT DEBIT

Mastercard

Please put the following reference: SST2014_Your Surname
Account Number: 01 1839 0036732 00
Swift (Routing) Number: ANZBNZ22
Account name: University of Canterbury
Bank name and branch: ANZ Bank, Auckland (Q&V)
Address : Corner Queen and Victoria Street, Auckland
Office use only::
Code: 21700:1980:217SST14:0:1
Send hardcopy CC to Cashiers and Direct Debit to Accounts Receivable via email
http://www.nzilbb.canterbury.ac.nz/SST.shtml
nzilbb@canterbury.ac.nz