Download Registration Form 2016 - Ecological Consultants Association

REGISTRATION FORM
Ecological Consultants Association of NSW
Annual Conference 2016
Monday 25th July at ‘The Briars’ 653 Mossvale Rd, Bowral
New Insights in Ecology
Name(s)___________________________________________________________________________________
(this will be the named displayed on your name tag)
Business Name_____________________________________________________________________________
Address____________________________________________________________________________________
Phone___________________________________ Email_____________________________________________
Special dietary requirements___________________________________________
Early Bird Registration (before 30th June)
□ $120 Member □ $150 Non-member
□ $80 Student
Late Registration
□ $130 Member □ $160 Non-member
□ $55 Dinner and Trivia Night
□ $90 Student
(must be paid in advance. Includes cocktail dinner, trivia and prizes, tea and coffee,
other drinks not included. Partners welcome to attend dinner and trivia without
attending conference)
Total Enclosed_______________________ Payment method________________
PLEASE NOTE
That this registration also forms an official tax invoice.
ECA of NSW is not registered for GST.
Ecological Consultants Association of NSW ABN: 85 213 648 549
Registration closes COB 2oth July 2016 and refunds will not be issued after this date.