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REGISTRATION FORM - MELBOURNE, SUNDAY 5 DECEMBER - MONDAY 6 DECEMBER

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Your Details:

Title _________First Name______________________ Last Name ____________________________________

Position _____________________________________ Company/Institution ____________________________

Address ___________________________________________________________________________________

Suburb/City____________________ State _______________Post Code _______________________________

Phone ____________________Fax _____________________Email____________________________________

Registration Details:

Two-day conference registration includes attendance at all sessions, morning and afternoon teas.
All prices include GST.

Please tick one

Waged

Non-Waged

Two Day Registration / Workshop & Meeting

$40

$25

Meeting Only (Lunch provided)

$10

$10

Total Registration Payable $______

A Conference Dinner is planned for Sunday evening. The cost is NOT included in the registration.
I will be attending the dinner on Sunday

Please print and complete this form and send it with payment to:

Mail:
Lisa Gye & Esther Milne
Media and Communications
Faculty of Life and Social Sciences
Swinburne University of Technology
P.O.Bx 218, Hawthorn, 3122 VIC

Fax:
Attention: Lisa Gye or Esther Milne
Media and Communications

03 98190574

Email:
Copy and paste this information into an email and send to Esther Milne [emilne@swin.edu.au] or Lisa Gye [lgye@swin.edu.au]

Please make cheques payable to:

Arrangements can be made to pay on the day - please contact Lisa or Esther to arrange.

Signature ________________________________ Date ________________

PLEASE NOTE: All proceeds from this event will go towards supporting the mySpinach independent server
http://www.myspinach.org/