Small Business Management Toolbox

ValleyView Publishing 12 Mountain Drive Jade Valley Victoria 3999

Phone (03) 9123 4567 Fax (03) 9123 7654 www.valleyview.com.au

Escape the Norm conference

Registration

Title: First name:

Surname:

Position:

Organisation:

Postal address:

Phone: Fax:

Email:

How to register

Return registration form together with payment to:

Mail
ValleyView Publishing
12 Mountain Drive
Jade Valley VIC 3999
(03) 9123 4567 / Fax
ValleyView Publishing
(03) 9123 7654
Registration fees / Payment method
Full conference
(includes cocktail party, speakers'
papers, meals and workshops)
Individual q $330
Corporate q $275
$
Additional tickets – Cocktail Party
No. of tickets required @ $80
per person
$
Total payment enclosed
$ / 1. Cheque (to follow/enclosed)
2. Credit card
q Bankcard q Mastercard
q Visa q Amex
Cardholder's name: ……………………………….
Card number: ………………………………………
Card expiry date: ………/…… /……..
Amount authorised: $………………
Cardholder's signature:………………………………..
Date:…../…… /………
Special rates
The following special rates apply for full conference registration:
§ if there are 5 delegates from one organisation, 50% discount for one delegate
§ if there are 10 delegates from one organisation, 100% discount for one delegate.