QUALCON 2014 Delegate Application

QUALCON 2014 Delegate Application

Qualcon 2014

Delegate Application

19 - 20 October 2011SebelPlayford HotelAdelaide, South Australia

Speaker Details

Surname
Given Names
Preferred First Name (for name tag)
Position
Organisation
Postal Address
Suburb / State / Postcode
Country
Telephone / Facsimile
Mobile / Email
Special Dietary Needs

AOQ Member Number:

Supporting Organisation MemberOrganisation:

I do not wish to have my name and address included in a public list of conference delegates:

Post Conference Workshop Details

To be held Thursday 23th October 2014.
Flow
Management Representative
Compliance Management
Lean / SixSigma
Plan on a Page
Quality Tools
Collaboration /

Accommodation Details

Standard Room $170.00
Contact the SebelPlayford Hotel & quote ‘Qualcon2014 Conference’ for discount rates.

Australian Organisation For Quality (South Australia) Inc

POBox 1291, Blackwood, South Australia 5051

Phone: +61 1800 725 850Fax: +61 8 8347 7240

Email:

Web site for LATEST information:
Payment Details (Prices include GST)

Speaker / Amount Payable
Full Registration ** / 495.00
Full Registration ** PLUS Workshop / 1265.00
Day Registration excludes Conference Banquet
Monday
Tuesday
Wednesday / 165.00
Accompanying Person ^ / 165.00
Conference Banquet Only / 125.00
Welcome Cocktails Only / Complimentary for Speakers
TOTAL PAYABLE:

* Early bird to be paid before 31 July 2014. ** includes Conference, Welcome Cocktails and Conference Banquet.
^^ A 15 % discount applies to registrations above three people from the one organisation when all registrations are received at the same time.
^ Accompanying Person covers Welcome Cocktails and Conference Banquet. Please complete a separate registration.

Payment is enclosed or Please send invoice, payable within seven days or
Charge my Credit Card or Direct debit

Cheques/money orders to be AUD and payable to Australian Organisation for Quality (South Australia) Inc.
Direct Debit to: BSB: 035-006, Account number: 25-8950, Account name: Australian Organisation for Quality (SA) Inc Branch:WESTPAC Pirie Street.

Credit Card Details:Visa Mastercard Bankcard

Expiry Date
CVV

*The use of the CVV for cards not present transactions is a requirement of AOQ (SA) Inc. The CVV is the three digit number that appears on the reverse side of your credit card.

Name of Card Holder:

Signature:______

Please return completed form and Payment/Purchase Order to AOQ(SA) Inc.

Terms and Conditions

SUBSTITUTIONS, WITHDRAWALS OR CANCELLATION

Each registration must be made in the name of a specific individual. Substitutions will be accepted on written notification. In the event that a delegate withdraws and notification is received in writing by the AOQ(SA) office no later than 17 August 2014, 50% of registration fees will be refunded There will be no refund for withdrawals after this time. In the event of cancellation of the conference, all registration fees will be refunded.

PROGRAMME CHANGES

It may be necessary, for reasons beyond the control of the organisers, to change programme content, speakers and/or timings. AOQ(SA) is not liable for any changes.

PRIVACY ACT

AOQ will hold all information provided by you registering for this conference in the strictest confidence and only use it as required for this and related events. Delegates’ names and addresses may be disclosed to conference delegates, sponsors or trade exhibitors for marketing purposes unless the box above is checked.

Issue 1.0Page 1 of 2

Approved: 20130923