Registration Form

(cost in NZ$ = approx € 0.55 or US$ 0.72)

Delegate details

(Full registration includes teas/lunches, and all Functions)

Title:
First name:
Surname:
Preferred name for badge:
Organisation:
Address: (please give full postal address)
Phone (Home):
Phone (Business):
Fax:
Email:
Mobile:

Accompanying Person

(Includes Opening & Welcome Function and Conference Dinner)

First Name:
Surname:
Preferred name for badge:

Special Requirements

E.g. (dietary, disability, etc)

Accommodation (GST inclusive)

These rates are only available if your booking is made through the Conference Organisers, so please indicate your preferences below.
Minimum Accommodation deposit per room - NZ$100.00

		Single	Double	Twin/Share*
Te Pania Hotel 45 Marine Parade, Napier	$159.75 per room per night
Quality Inn Hotel 311 Marine Parade, Napier	Deluxe Room $134 per room per night
Quality Inn Hotel 311 Marine Parade, Napier	Seaview Room $187 per room per night
* I've arranged to share a room with:

Arrival Date:
Departure Date:

Activities

Pre-conference Workshop
Separate registration required once funding is confirmed.
Please indicate if you wish to attend:

Yes
No

Pre-conference Tour
If you wish to attend please select preferred accommodation:

Single
Double
Twin/Share*

*If Twin/Share please advice who will be sharing with:

Privacy act

My name and address may be included on any list to be circulated to delegates and exhibitors.

Yes
No