2-3 September Gold Coast International Hotel REGISTRATION FORM

If you wish to register for CMGA'99 please PRINT this form, complete details and either:

Fax with credit card details to:
+61 2 9969 3481
or
Mail with payment to:
CMGA'99 Conference,
PO Box 989,
CROWS NEST, NSW 1585, Australia.

Please Circle Mr  Mrs  Miss  Ms   Dr

Surname……………………………………………………………………………………………………………………

Given Name………………………………………………………………………………………………………………

Position/Title ……………………………………………………………………………………………………

Company…………………………………………………………………………………………………………………

Postal Address ………………………………………………………………………………………………

State………………..Postcode……………………………………………………………………………………………

Country……………………………………………………………………………………………………………………

Telephone…………………………………Fax …………………………………………………

E- mail……………………………………………………………………………………………………………………

Preferred Name for Badge ………………………………………………………………………………………………

How did you find out about CMGA'99?(please tick)

CMGA Mailout   Advertisement   (which publication?) ……………………………

Other………………………………………………………………………………………………………………………

I agree to be bound by the Articles of Associations and Policies of CMG Australia Ltd ACN 003 158 030

Signature……………………………………………………… …………………………………………………………

Registration

Full Conference Registration (with accommodation)
Includes two day attendance at conference, two nights accommodation at conference venue, conference dinner and CMGA membership.

$1400 

Full Conference Registration (without accommodation)
Includes two day attendance at conference, conference dinner and CMGA membership.

$1285 

One day Registration (without accommodation) $685 

Thursday 2nd  Friday 3rd 

Speaker Registration

Full two day attendance at conference $915 
Includes two day attendance at conference, two nights accommodation at conference venue, conference dinner and CMGA membership.

One day registration on the day of presentation No charge 

Attendance at Social Functions for full two day registration

I will be attending the social events which are included in the Conference registration fee.

Yes No 

Special Dietary Requirements…………………………………………

Partner/Guest/One day speaker social registration

For partner/guest or single day speaker at the social events on Thursday evening.

Name for badge …………………………………………………………………………………………………………

Thursday Dinner @ $ 95 $……………………..

Special Dietary Requirements…………………………………………

I cannot attend

 however, I would like to join CMGA

 however, I would like to renew my membership

Membership Renewal Only

Postal address within Australia $135 

Postal Address outside Australia $160 

Total Payment Enclosed $_____

How to Pay

By cheque in AUD, payable to CMGA'99 Conference

By Credit Card - please tick choice
Bankcard Mastercard Visa American Express

Card Number…………………………………………………………………
Expiry date……………………………………………………………………
Name of Cardholder…………………………………………………………
Signature of Cardholder……………………………………………………

PLEASE PRINT AND RETURN THIS FORM WITH PAYMENT TO:

CMGA'99 Conference,
PO Box 989,
CROWS NEST, NSW 1585 Australia.

REGISTRATION ENQUIRIES

Telephone +61 2 9969 1299  Fax +61 2 9969 3481