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Дата индексирования: Mon Oct 1 22:13:19 2012
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Research School of Astronomy and Astrophysics The Australian National University ABN 52 234 063 906 5 4
TH TH

STROMLO SYMPOSIUM
MLO

TO

8TH DECEMBER 2006, MT STRO

OBS

ERVATORY,

CAN

BERRA

, AUSTRALIA

REGISTRATION FORM / TAX INVOICE
This document is a TAX INVOICE when payment is made. Please retain a copy for taxation purposes when making payment for the GST inclusive fee.

(Please print clearly) Title Family Name/Surname Institution Mailing Address Email

First Name/Initials

Country Ph

Post Code Fax

Guests (must provide details if attending Welcome Reception or Dinner) Title First Name Surname Title First Name Surname
REGISTRATION FEES Standard Registration Student Registration CONFERENCE DINNER Will you be attending? Guest(s) WELCOME RECEPTION Will you be attending? Guest(s) attending YES / NO No cost for participants $30 $ 0.00 $ Early Bird (before 15 October) $550 $440 QTY YES / NO Full Price (after 15 October) $650 $540 COST $80 $80 Sub Total $ $ Sub Total $ $

Note: All prices above include GST and are shown in Australian Dollars (AUD). TOTAL FEES: AUD$_______________ (Total includes GST)

Page 1 of 2


The conference registration fee covers all conference sessions, welcome reception, lunches and morning and afternoon tea each day. A copy of the conference abstracts and of the conference program will be available at registration. All registrants are encouraged to attend the Conference Dinner, which will be held at University House, one of Canberra's finest restaurants. Guests are not required to register for the conference in order to attend the Conference Dinner or the Welcome Reception but must indicate attendance as a guest on the registration form. METHODS OF PAYMENT Total remittance in Australian Dollars (AUD$), by cheque or money order Australian National University. Cheques must be in Australian Dollars. remittance do not constitute advance registration. Registrants claiming the evidence of student status. To pay by credit card please complete the form Mail or fax form and payment authority to: 5th Stromlo Symposium Mt Stromlo Observatory The Australian National University Mt Stromlo Rd Weston ACT 2611 Australia T: +61 2 6125 8905 F: +61 2 6125 0233 E: 5SS@mso.anu.edu.au and made payable to The Forms received without student rate must submit below.

Name of Registrant Type of card Name on card Card Number Signature Cardholder Email (if different from registrant) MasterCard

Please charge my card VISA Bankcard

AUD$

Exp Date Date Cardholder Phone

CANCELLATION AND REFUND Registrants may withdraw their registration prior to 1 November 2006. All refunds will be subject to an AUD$50 (inc GST) administration fee. No refunds can be made for cancellations received after 1 November 2006. SPECIAL REQUIREMENTS Please tick this box if you have special dietary requirements (eg. Vegetarian, gluten free) Describe_______________________________________________________________________________