Registration

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Registration Form is now closed

Please contact the Congress Secretariat (6ibc2010@gmail.com).

First Name:

Family Name:

Title:

Preferred name (For badge):

Institution/Organisation:

Institution's Address:

City:

Country:

Postcode:

E-mail:

Telephone number:

Fax:

I am registering as a:

I would like to be a:

Your preferred excursion(s):

Click here to select your preferred excursion(s)

E1: Western Australia, $900.00
E2: Sydney Basin, $800.00
E3: New Zealand, $900.00 ($1350.00 dive)
E4: Central New South Wales, $1000.00
MID 1: Devonian, $70.00
MID 2: Permian, $60.00
MID 3: Tertiary, $50.00

Congress Dinner

I would like to attend the congress dinner $80

Special Meal Requirement

Click here to indicate any special dietary requirements

Vegetarian
Vegan
Gluten Free
Halal
Orthodox Kosher
Other Req
Allergy to

Total Payment *

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Total amount in Australian Dollars $
I have paid by	Direct Deposit	Date Transferred
I have paid by	Cheque/International bank draft/Postal order	Date Posted
	Credit Card Payment
	Click Here to download form

Privacy Statement
This information is collected for the purposes of processing your registration or inquiry for the congress. Information that we collect will be used for keeping you informed of the event. This information will not be supplied to a third party.

Cancellation Statement
Cancellations received in writing to the Congress Secretariat by 1 December 2009 will be accepted and all fees refunded less a AUD $50 administration fee. Cancellations received between 1 December 2009 and 15 January 2010 will be accepted and 50% of fees will be refunded. Cancellations received after 15 January 2010 cannot be accepted and will not be refunded, however transfer of your registration to another person is acceptable. The full name and details of the person that will replace you, must be advised in writing to the Congress Secretriat prior to the Congress. No refunds will be made for non-attendance at the Congress.

Note: Some of the images used on title are aquired from http://www.melbourne.vic.gov.au

Additionally the City of Melbourne do not sponsor this conference in any way.