v4    
 

Accommodation registration

1. Personal details of delegate

Name

*Required

Organisation

Email
I require a   
   

2. Accommodation Details
Arrival date Select Date Departure date Select Date
Arrival time Departure time
Total nights

3. Accommodation venue and room type

Please indicate accommodation venue and room type

A. Novotel Rockford (Symposium Venue )
No of Nights Required: Room Type Price
nights Superior Room $180 per night
nights Executive Room $220 per night
nights Bedroom Apartment $320 per night

B. Grand Mercure Rockford Esplanade 

No of Nights Required: Room Type Price
nights Studio Room $152 per night
nights 1 Bedroom Apartment $259 per night
nights 2 Bedroom Apartment $369 per night

C. Angsana Resort and Spa Palm Cove
Angsana
No of Nights Required: Room Type Price
nights 1 bedroom pool view $297 per night
nights 1 bedroom beachfront $357 per night
nights 2 Bedroom pool view $348 per night
nights 2 Bedroom beach front $408 per night
nights 3 Bedroom pool view $405 per night
nights 3 bedroom beachfront $465 per night

3. Transfers

I would like transfers from the airport
No of persons travelling Flight Details Cost
pax $17 per person

I would like transfers to the airport
No of persons travelling Flight Details Cost
pax $17 per person

Total cost of accommodation

Currency Conversion:
Please Note: Currencies as at 7 May 2008.
Comments/Special requests:

All prices are in Australian Dollars, valid until 1 August 2008 and include GST

4. Payment Method:
Credit Card payment: Yes
Credit Card Type:
MasterCard Visa
Card Holder Name:
Card Number:
CVV:
Expiry Date:
OR  
Direct Bank Transfer Yes  
Deposit Funds to : The A List Event Connections,
BSB  114 879
Account: 057593548
Please ensure you put your name as a reference for the payment.
OR
I will mail a Cheque, Money Order or Bank Draft Yes
Make out to:  The A List Event Connections
PO Box 733
EDGE HILL  QLD   4870 
 

Please send my confirmation of payment to:
Email address
Postal address
Please confirm your email address

Collection of Personal Information

When you e-mail us:
  • we will record your e-mail address
  • we will only use your e-mail address for the purpose for which you provided it
  • we will add your e-mail address to our mailing list for updates about this symposium and any follow-up events
  • it will not be added to any other mailing list
  • we will not use your e-mail address for any other purpose
  • we will not disclose your e-mail address without your consent except where we may be required by law to disclose certain information.
Should you decide to use the on-line form:
  • we will record your name, e-mail address, and other personal information provided
  • we will only use this information for the purpose for which you provided it
  • we will add this information to our mailing list for updates about this symposium and any follow-up events
  • it will not be added to any other mailing list
  • we will not disclose this information without your consent except where we may be required by law to disclose certain information.
We will, at your request, provide you with access to any information which we have collected about you through this website in accordance with Information Privacy Principle 6, Privacy Act 1988 (Cth). To gain access to this information you should contact us. If you believe that any information is inaccurate, incomplete or out of date, please contact us and we will revise the relevant information in accordance with Information Privacy Principle 7, Privacy Act 1988 (Cth).
secure booking form - justpurple