Date: September 2010
Venue: TBA Melbourne
Registrant Details:
Title: Your Name (required):
Your Organisation:
Your Address (required):
Suburb/Town (required):
State (required): Postcode (required):
Work Phone (required):
Your Email (required):
Are you an IPWEA or CCF member? yes no
TAX INVOICE
Institute of Public Works Engineering (Victoria Division) Limited (ABN 95 088 509 399)
This registration form is a tax invoice for GST purposes when you make a payment
Payment method: Credit Card Direct deposit Cheque Please send invoice
Credit Card Details:
Type: Visa MasterCard
Name on Card:
Card Number: /// Expiry Date: /
Payment Amount: IPWEA or CCF members $475 Non-members $495
Payment amount is inclusive of GST.
If paying by Direct Deposit, please make a deposit for the appropriate amount to: Account Name: IPWEA Vic BSB: 063 633 Account Number: 1014 5355 Please include "MOD211" in the payment details and make sure that your name is indicated in the "payment from" field, or alternatively notify us as soon as payment is made.
If paying by cheque, please print this form and send to IPWEAvic, PO Box 1254 Geelong Vic 3220 with your cheque.
If paying on invoice, please provide an order number:
Terms and Conditions:
Payment Terms: Full payment is required with this registration.
Refund Policy: Where a participant is confirmed in a course and fails to attend, the full course fee will be charged. If a cancellation is made by a participant within five (5) working days prior to the course commencement date, the participant will be charged the total of the course fee unless a suitable replacement is found.
Cancellation Policy: IPWEAvic reserves the right at any time and without prior notice to change the venue/presenters or program from that described in the brochure or on line. IPWEAvic also reserves the right, at its absolute discretion and without further liability, to cancel or postpone any program. In such case participants may attend the next available course free of any transfer or other administrative fee.
This form may be submitted by pressing the "Send" button below or by printing this form and faxing it to IPWEAvic (03) 5250-3008 or mailing it to IPWEAvic, P O Box 1254 Geelong Vic 3220. By submitting this form you are agreeing to these terms and conditions and to pay the fee indicated.
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