abn 84 866 293 264

http://www.agcts.org.au/

10th Scientific Meeting of the Australasian Gene and Cell Therapy Society (AGCTS), Australasian Society of Stem Cell Research (ASSCR)

Registration Details

Title / Name
Organisation
Address
Post code
Contact Phone / Email
Fax / Date / _ _ | _ _ | _ _ _ _

Registration Options

Full conference registration includes: *catering (3 days), conference satchel & abstract book, JGM abstract publication.

Day registration includes: *catering on nominated day(s), conference satchel & abstract book and JGM abstract publication.

*Catering includes: welcome drinks & canapés Wednesday evening 24 May, lunch, morning & afternoon refreshments daily.

Early Bird Registration - Before Friday 10th February 2017
*Full Conference / *Day Registration / Nominate Day
Member / $480 / $250 Wed Thu Fri
Non-member / $700
Student member / $350
Non-member student / $470
Late Registration - After Friday 10th February 2017
*Full Conference / *Day Registration / Nominate Day
Member / $580 / $250 Wed Thu Fri
Non-member / $800
Student member / $450
Non-member student / $570
Invited Speaker (Full conference registration waived)
Conference Sponsor (Full conference registration waived)
Conference Dinner: Captain Cook Sydney Harbour Dinner Cruise, Thursday 25 May 2017, 6.45pm No.1 King Street Wharf, Darling Harbour
$130 per member or guest No. of tickets: Guest Name:
$100 per student member or student guest No. of tickets: Guest Name:
Special Dietary Requirements:
Total:

* All amounts must be in Australian dollars (AUS$) drawn on an Australian Bank

I wish to pay by bank transfer:

Please email form to Prof. Simpson with bank receipt at

Commonwealth Bank of Australia

BSB: 06 2005

Acct: 1132 5372

OR

I enclose my cheque for $ ……………….

Cheque payment: Please post form & cheque, payable to Australasian Gene and Cell Therapy Society to:

Professor Ann Simpson

School of Life Sciences, University of Technology, Sydney

PO Box 123, Broadway, NSW 2007, AUSTRALIA

1 Please tick if you require a receipt

* I certify that the above applicant is a student and is not in receipt of a full-time salary

……………………………………… Supervisor/Department Head