Given Name __________________________________________________________________________________

Family Name __________________________________________________________________________________

Title __________________________________________________________________________________

Company __________________________________________________________________________________

Street Address __________________________________________________________________________________

City __________________________________________________________________________________

State __________________________________________________________________________________

Postal Code __________________________________________________________________________________

Work Phone __________________________________________________________________________________

Home Phone __________________________________________________________________________________

Fax __________________________________________________________________________________

E-Mail __________________________________________________________________________________

 

Date of Workshop: (Tues 23rd August 2005, Tues 6th Dec 2005, Tues 4th April 2006)

__________________________________________

 

Event Registration:

$199 Australian Dollars
GST Inclusive

 

Method of Payment:

Credit card: Visa Mastercard Bankcard

Card number	______ /______/______/______
Expiry Date	___/___
Cardholder Name:	_____________________________________________
Cardholder Signature:	_____________________________________________

Cheque:

Payable to: Macquarie Institute pty ltd.
PO Box 1197, Chatswood, NSW 2057

 

Cancellations must be received by 2 weeks prior to your chosen event and are subject to a $50 cancellation fee, or if desired your fees may be transferred to a future course booking.

Inquiries: Att: Maria Thompson Macquarie Institute Pty Ltd, Tel: 9412 2500, Fax: 9403 7900,
Email: info@macquarieinstitute.com.au

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