From: [required-email-address] To: hamiltok@usq.edu.au Cc: [required-email-address] Subject: REGIS for ASET-HERDSA 2000 by [required-name] REMINDERS: Save this email as a text or word processor file, for your records. For credit card payments by fax or mail, or cheque payments, please undertake the further action detailed in either a. or b. below in order to complete your registration. Title and name: [required-name] Preferred name for badge: [required-badge-name] Postal address: [required-postal-address] Organisation: [required-organisation] Phone - work: [required-phone-work] Phone - home: [phone-home] Fax: [fax] Email address is: [required-email-address] Special requirements regarding health, diet, etc: [special] Partner's Program: [partners] Pre-Conference Tours: [preconf-tours] Coach Transfer: [coach-transfer] Membership: [herdsa-memb] [aset-memb] Join a Society: [join-aset] [join-herdsa] Type of Registration: [earlybird-regis] [standard-regis] [monday-regis] [tuesday-regis] [wednesday-regis] Residential Colleges: [rescoll-sun] [rescoll-mon] [rescoll-tues] [rescoll-wed] Total Res College payable $: [total-rescoll-payable] Student Village: [stuvill-sun] [stuvill-mon] [stuvill-tues] [stuvill-wed] Total Stu Village payable $: [total-stuvill-payable] Extra conference dinner tickets $: [extra-dinner-tickets] Grand total $: [required-grand-total] My payment method is: [pay-cat1] [pay-cat2] [pay-cat3] Only for credit card payment via this page: Card type: [card-type] Name on Credit Card: [cardholder-name] Credit Card number: [cna] [cnb] [cnc] [cnd] Card expiry date: [card-expiry] Amount to be debited: [card-amount] REMINDERS: Save this email as a text or word processor file, for your records. For credit card payments by fax or mail, or cheque payments, please undertake the further action detailed in either a. or b. below in order to complete your registration. a. Credit card via fax to USQ Meetings & Events. Type your credit card details into the appropriate lines above, save again, and print your fully completed form. Please sign the printout here: Your signature: _______________________________ Fax to USQ Meetings & Events fax number +61 7 4635 5550 b. Cheque/Credit Card via postal service to USQ Meetings & Events. In the case of payment by cheque, prepare a cheque payable to The University of Southern Queensland, Meetings & Events (cheques must be in Australian dollars). Print your fully completed form and with enclosed cheque post to USQ Meetings & Events. In the case of credit card via post, type your credit card details into the appropriate lines above, save again, and print your fully completed form. Please sign the printout here: Your signature: _______________________________ Post to USQ Meetings & Events, PO Box 282, Darling Heights Qld 4350, AUSTRALIA Thank you for registering for ASET-HERDSA 2000!