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The Australian National University
Disability Services Unit
Student & Academic Services (SAS)
 
 
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PROFESSIONAL DEVELOPMENT DAY 4th April, 2007
Members REGISTRATION FORM/INVOICE
Members: $25 Non-members $35

A.B.N 59 884 972 977

Name:                                                                                                       

Position:                                                                                                    

Organisation:                                                                                            

Address:                                                                                                    

Telephone:                                               Mobile:                                       

Email:                                                        Fax:                                          

Member: Non-Member:

Special Requirements:

Please tick if you require any of the following:

Large Print

Electronic Format

Signing Interpreter

FM Hearing Loop

Accessible Parking (RTA Disability Sticker required)

Dietary requirements (specify):                                                                  

Please Return to:

Please reply by fax or email to:

Timothy Hart
Fax: 9807 7053
Email: thart@med.usyd.edu.au
Telephone: 8878 0514

RSVP Closing Date: 30th March, 2007

Payment methods:

Cheque

Make cheques out to DISABILITY EDUCATION ASSOCIATION Inc. and post to:

DEAN Inc.
P.O. Box 1045
MEADOWBANK, NSW 2114

Cash

Cheques and Cash may be presented to the DEAN Treasurer at a DEAN Professional Development Day

Direct Debit

Please make your direct debit to:

Name: DISABILITY EDUCATION ASSOCIATION
Acc. #: 10100725
BSB #: 06 2173

Electronic Payment Details:

Date paid in: _____________________ Amount: $______________

Your Bank's Electronic receipt number for the transaction: ______________

Please maintain any documentation you receive of the transaction. Then either post this receipt to:

DEAN Inc.
P.O. Box 1045
MEADOWBANK, NSW 2114

Or send it electronically to thart@med.usyd.edu.au

A.B.N 59 884 972 977

TAX INVOICE

(Not for Profit Organisation below Income Threshold - not required to register for GST)

Date: 4th April, 2007

Item No.
Item
Amount
1
DEAN Inc. Professional Development Day Members Fee, (GST exempt)
$25.00
2
DEAN Inc. Professional Development Day Non-Members Fee, (GST exempt)
$35.00

 

Total (Member): $25.00

Total (Non-Member): $35.00

DEAN PD Day Registration
Page last updated: 09 August 2004
Please direct all enquiries to: Disability Liaison Officer
Page authorised by: Disability Liaison Officer
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