Registration Form / Tax Invoice
The University of Adelaide - ABN 61 249 878 937
Complete this form and post with payment to:
Centre for the Molecular Genetics of Development
Room 1.27, Molecular Life Sciences Building
The University of Adelaide, Adelaide SA 5005, Australia
or fax to: 08 8303 7534
This registration form constitutes a tax invoice upon payment
Australia & New Zealand Zebrafish Workshop
2nd – 4th February 2009
Whalers Inn Resort, Victor Harbor, South Australia
 DEADLINE FOR REGISTRATIONS: FRIDAY, 10th OCTOBER 2008 
Abstract Deadline is 1st November 2008
A. REGISTRATION FORM (Please print clearly using block letters)
Family Name:
First Name:
Title (Prof/Dr/Mr/Ms/Miss):
Gender (Please circle)
Preferred Name for Badge:
Male / Female
Dietary Requirements:
Department:
Institution:
Postal Address:
Street, Building or P.O. Box
City / Town
Phone Number:
(
State
)
Facsimile Number:
(
Postcode
)
Email Address:
(The fees listed below are in AUD and include Goods & Services Tax)
B.  DISCOUNTED STUDENT PACKAGE  (20 packages available)
 $440 (Includes registration, all meals, Adelaide-Victor Harbor transfer, shared accommodation)
Total B: _________
C. REGISTRATION FEES (Non-students)
 $520 (Includes all meals, Adelaide-Victor Harbor transfer)
Total C: _________
D. ACCOMMODATION (Cost for 2 nights – 2,3 Feb)
 3 bedroom apartment (1 bedroom with QS bed, 2 bedrooms with 2 single beds each)
 Shared accommodation $150 p.p. Sharing with ___________________________________ Total D: _________
 1 bedroom apartment (1 bedroom with QS bed and sofa bed) limited numbers available
 Single or
 Double
$300
 Share twin (QS bed and studio bed) $190 p.p. Sharing with ______________________
Total D: _________
E. PRESENTATION
 I intend to submit an abstract by  1st November 2008  Please submit abstract via Zebrafish09 website online form
Tentative oral presentation title (to assist in session arrangement) _______________________________________
Zebrafish Husbandry Workshop
5th February 2009
University of Adelaide, South Australia
Following the 10th A&NZ Zebrafish Workshop, the Zebrafish Husbandry Workshop will be held at the University of Adelaide on 5th
February 2009. Delegates attending the A&NZ Zebrafish Workshop on 2-4 February are asked to book their own accommodation in
Adelaide for the night of February 4th, 2009.
F. Zebrafish Husbandry Workshop REGISTRATION FEES
 $50 (Includes morning tea and light lunch)
Total F: _________
Grand Total B-F: _________
Please refer to page 2 for payment details.
Page 1 of 2
Name of Registrant: _________________________________________________________
Method of Payment (Tick as appropriate)
 Cheque (Cheques should be made out to The University of Adelaide)
 Visa  Mastercard (No other cards accepted)
NOTE: Print form and post or fax to address at top of this form.
Card No:
Expiry Date:
Name on card:
Amount:
AUD
Signature:
CANCELLATION:
A cancellation fee of $100.00 applies. Please note that refunds will not be issued if cancellation occurs after 21 December 2008.
LATE REGISTRATIONS:
A late registration fee of $100.00 applies.
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