28TH IPS
REGISTRATION

To receive a Registration Form see below or please contact:

    Dr. Ken Smit,
   DSTO Salisbury,
 WSD, Building 307 EOP,
Salisbury, South Australia,
AUSTRALIA, 5108

PH: +61 - 8 - 8259 6737
FAX: +61 -8- 8259 6585
    E-mail: adelaide.ips@dsto.defence.gov.au

Tax Invoice

                                                                                                                                        ABN  68706814312

REGISTRATION FORM

 NAME* __________________________________________________________

 COMPANION NAME*_______________________________________________

 ORGANISATION* __________________________________________________

 CONTACT ADDRESS_______________________________________________

 ____________________________________________________State_______

 Country________________________________Postcode__________________

 PHONE:_______________________________________________________________(BH)

 FAX NUMBER: ____________________________________________________

 E-MAIL ADDRESS: ________________________________________________

 *show names and organisation as you want badges to read

 

To assist us with planning, please complete the following.

 

I and my companion plan to participate in the following activities:

Self           Companion      

Monday, 5th Nov
Cocktail Evening                             (   )                   (   )

Tuesday, 6th Nov.
Evening Picnic, Botanic Garden   (   )                   (   )

Wednesday, 7th Nov.
Barossa Valley Excursion              (   )                   (   )

Thursday, 8th Nov.
Evening Banquet, Ayers House     (   )                   (   )

 

Return Address:

Dr Ken Smit, 28th IPS Conference Coordinator
WSD, Building 307 EOP, DSTO
PO Box 1500, Salisbury, SA 5108
 Australia
Ph: +61-8-8259-6737; Fax: +61-8-8259-6585
E-mail: adelaide.ips@dsto.defence.gov.au

 

 Fill in amount for applicable fees in Australian dollars# and then total

 Member Registration**….…………………., before 7th October, A$ 935    ______

Member Registration …….…………………., after 7th October,   A$ 990    ______

 Non-Member Registration…………………., before 7th October, A$  990    ______

Non-Member Registration…………………..., after 7th October,  A$1045    ______

 Retired or Full Time Student Registration, ……………….……...A$  660    ______

 Companion Monday Cocktail Evening@, ………………………...A$    22    ______

Companion Tuesday Evening Picnic Dinner@,………………….. A$    22    ______

Companion Wed. Barossa Valley Excursion##, …………………..A$    58    ______

Companion Thursday Evening Banquet@, ……………………… A$    40    ______

Companion Lunches, ……. Mon.__Tue.__Wed.__Thu.__Fri.__  A$  22 ea. ______

                                                                               Total Fees Due  A$             ______

 Only VISA or Mastercard credit cards can be used to pay fees.  Alternatively bank drafts, international money orders or cheques in Australian dollars at Australian Banks  payable to “28th International Pyrotechnics Seminar c/- RPM”. 

 To pay by credit card, tick   VISA (   )     Mastercard  (   )

 Credit Card Number:_______________________________ Expires:_________

 Signature:_____________________

 #  At current exchange rates A$990 is US$505.  Payment is required in Australian dollars.

 **Registration includes Proceedings, satchel, morning/afternoon teas, cocktail evening, picnic dinner, Barossa Valley excursion, banquet, 5 lunches.  All fees include compulsory 10% GST  (Goods and Services Tax).  Fee assessment date is date registration form information is received.

 @ Conference providing approx. half subsidy of these activities for companions.  

 ## Barossa Valley Excursion by train & bus may be limited; placements are on a first come basis.  Numbers exceeding 152 places will have bus transport.