5: group registration-A: Ninth Learning Conference, Beijing, CHINA

group registration booking form - A

First Delegate's Particulars

Group Particulars & Registration

Accommodation Options

Payment Options

Submission Section

Regn only

Regn / Accom

Virtual Regn

Group Regn A

Group Regn B

Accom / Dinner

- If the registration fee is to be paid in full and in one payment by an institution or an individual for all members of the group you may use this form to register.

- If individual payments are to be made, thus requiring separate invoices, please go to the alternate form at this link

FIRST DELEGATE'S PARTICULARS

Enter full details of first person in this section, then proceed to next section, Group Particulars & Registration, to enter details for remaining persons and to complete your registration.

(1)	Title: (e.g. Ms, Dr, Assoc. Prof.)
(2)	Given Name
(3)	Family Name
In this box enter your full name in your preferred order as you wish it to appear on correspondence and invoices - alternatively the default will apply, this being in the order of 1, 2, 3 as entered above
	Position in organisation
	Name of Institution / School / Organisation / Department
	Address of above
	Alternative/Home Address
	Work Tel
	Work Fax
	Home Tel
	Home Fax
	Mobile
	Email
	Comments / Notes / Invoicing details, etc. If you have any specific requests please advise us (eg. Dietary requirements; Attendant care needs)

GROUP PARTICULARS & REGISTRATION - to book, tick appropriate boxes, fill in details, and enter $ amounts below
(five participants $US 1750.00)

Registration Includes
- Evening Welcome Reception (Tues 16 July 2002)
- All Plenary and Parallel Sessions
- Lunches, Morning & Afternoon Teas for the 4 days of the conference (Wed 17 - Sat 20 July 2002)

Conference Dinner
The Conference Dinner is an optional extra and will be held on Friday 19 July beside the water fountains of the Friendship Hotel forecourt

NAMES OF GROUP MEMBERS Title (Ms, Mr, Prof.) / First Name / Last Name & Position of each group member	CONTACT DETAILS Name of School/Organisation/Institition; Address; Contact Details (phone, etc.)	Dinner @ $US55 pp To book dinner for members of the group, tick box next to name
	enter name only of FIRST PERSON	1
enter full names of the remaining members of the group	enter contact details for the rest of the group if this information differs from that of the first person
		2
		3
		4
		5
		6
		7
		8
		9
		10
Total number of persons registered:	Total number of dinner bookings > (including family members not registered for conference)
Group Registration - Five Participants: $US 1750.00 (calculate fee for additional persons at the pro-rata Group Rate of $US 350 per person)
Total Registration amount: $US	Total Dinner amount: $US

ACCOMMODATION OPTIONS - to book, tick appropriate boxes, fill in details, and enter $ amounts below

ACCOMMODATION OPTION 1
Beijing Friendship Hotel (click here for information)

SINGLE: $USD 80.00 per night (including breakfast & service taxes)

TWIN-SHARE: $USD 40.00 per person per night (including breakfast & service taxes)

Check-in Date

Check-out Date

Number of Nights

Number of Rooms

Name/s of guest/s to be accommodated in each room

Special requirements (eg. Dietary ; Attendant care needs)

ACCOMMODATION OPTION 2
Beijing Olympic Hotel (click here for information)

SINGLE: $USD 52.00 per night (including breakfast & service taxes)

TWIN-SHARE: $USD 26.00 per person per night (including breakfast & service taxes)

Check-in Date

Check-out Date

Number of Nights

Number of Rooms

Name/s of guest/s to be accommodated in each room

Special requirements (eg. Dietary ; Attendant care needs)

$US
Total Friendship Hotel Accommodation Cost $US
Total Olympic Hotel Accommodation Cost

You will be advised once your booking has been confirmed

Payment Options (choose one from the Cheque or Credit Card options below)

    PAY BY CHEQUE

     in the amount of: $US

     cheque to be made payable to:

'Common Ground Conferences'

POST TO:
Learning Conference 2002
PO Box K481 Haymarket NSW
AUSTRALIA 2000

Conference managed by
Common Ground Conferences

    PAY BY CREDIT CARD

I authorise the amount of $US to be processed on my credit card

Card Type: (nominate card below )

Mastercard Bankcard Visa Amex

Cardholder's Name

Credit Card Number

Expiry Date (MM/YY)

Current Date (DD/MM/YY)

Signature: __________________________
(If submitting a printed form)

Australian Federal Goods and Services Tax:
GST not applicable

Please note that submitting this form does not result in an automatic transfer of funds from your credit card account. The transaction is processed manually only after the final cost has been confirmed - an invoice will be issued and confirmation of your credit card authorisation will be sent to you.

  TO REGISTER AND PAY BY CHEQUE: TO REGISTER AND PAY BY CREDIT CARD:

Register electronically by completing this form & pressing the submit button.
Your registration will be acknowledged by email and an invoice forwarded to facilitate your payment.
Confirmation will be made upon receipt of your payment in the post.

Complete this form and press the submit button.
Acknowledgment will be sent by email and confirmed in the post.
Alternatively, print a copy of the completed form
and fax to (+61) 02 9591 5762
or post to: Learning Conference 2002
PO Box K481 Haymarket NSW AUSTRALIA 2000.

Please complete this last section before submitting form:

FULL NAME (required):
COUNTRY:

EMAIL (required):

- Once you have checked your entries on this form and completed this section, press the <Submit> button once only.
- The contents of your submission will appear in your browser window and you may print a copy for your records.
- Your submission will be processed and an acknowledgement/confirmation, together with the full submission details, will be sent to you by email.
- Should you need to make any changes, this may be done after you have received the email.

Learning Conference 2002, PO Box K481 Haymarket NSW AUSTRALIA 2000
Tel: +61 (0)2 9591 5661 FAX to: +61 (0)2 9591 5762

Group Regn A

Cancellation Policy on registration, accommodation , dinner & transfers: To 30 June 2002, 85% refund. After 30 June 2002, 60%