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REGISTRATION FORM / TAX INVOICE

Please register me for the 11th State Conference of the Queensland Association for Gifted & Talented Children Inc, from Friday 22nd March to Sunday 24th March 2002 in Hawken Engineering Building, University of Qld, St Lucia.

Name for badge:

Email:

Phone, Home:

Work:

 Fax:

Mailing Address:

Town/suburb:

Postcode:

School Address:

Town/suburb:

Postcode:


Please tick (to comply with privacy laws).   I hereby permit QAGTC to contact me about future events.

Full registration includes

(All delegates are welcome to the Friday Evening program.)

Full Registration:

 

Part Registration:

 

Part Registration:

 

Children's program:

  Number on Saturday: on Sunday: @ $22/child/day

 

 Additional convivium tickets for non-registrants: @ $11 each

 

 Prices include 10% GST  (QAGTC Inc. ABN: 46 866 103 154) Total amount  

 
 This document will be a tax invoice when you make payment. Please retain an original copy.
* for membership information, please see   www.qagtc.org.au

     

If paying by credit card,        
Name on card: 
Card No.:

Expiry Date:

Signature:
If paying by cheque, please make the cheque payable to QAGTC Inc.

Mail to:    QAGTC Inc, 282 Stafford Rd, Stafford, Qld 4053 or Fax to: 07 3352 4388
   (Payment with registration, by 17th March, please. Late registration does not include lunch!)
Enquiries: phone 07 3352 4288 email: office@qagtc.org.au

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