REGISTRATION FORM & TAX INVOICE

Art and Human Rights

8–10 August 2003

For credit card payment, mail or fax to:
Leena Messina, Programs Manager,
Humanities Research Centre, Building 73, Lennox Crossing, Australian National University, Canberra ACT 0200;
or print and fax it to The Programs Manager, Humanities Research Centre on
+61 2 6248 0054.
Enquiries +61 26125 4357

TITLE
NAME
ADDRESS
DEPARTMENT
INSTITUTION
TELEPHONE
FACSIMILE
EMAIL

STUDENT NO.

THIS DOCUMENT WILL BE A TAX INVOICE FOR GST WHEN YOU MAKE A PAYMENT

AUSTRALIAN NATIONAL UNIVERSITY ABN 52 234 063 906

THE CONFERENCE IS OPEN TO ALL UPON PAYMENT OF THE REGISTRATION FEE

PLEASE CHECK THE APPROPRIATE BOX

All fees below include GST

Conference registration fee covers morning and afternoon teas and lunches on Friday and Saturday, morning and afternoon teas are included on Sunday, and two receptions on Saturday and Sunday evenings.
Please indicate special dietary or other needs by email

FULL RATE ALL DAYS EARLY BIRD BY 21 JULY $190
FULL RATE ALL DAYS $225.00
FULL RATE SINGLE DAY $95.00

CONCESSION/STUDENT RATE ALL DAYS $80
CONCESSION/STUDENT RATE DAILY RATE $50
INSTITUTION AND STUDENT NO.
ENTER YOUR TOTAL

* Some of the items on this tax invoice may appear on another tax invoice. It is your responsibility to ensure that GST is only claimed once for each item

SINGLE DAY REGISTRANTS:
Please indicate which day you wish to attend:

BY SUBMITTING THIS FORM ELECTRONICALLY YOU ARE REGISTERING YOUR ATTENDANCE

CANCELLATION WILL INCUR A $15 ADMINISTRATIVE FEE

You make payment by either of the following methods:

CHEQUE made payable to the Australian National University

OR

CREDIT CARD DO NOT SUBMIT YOUR CREDIT CARD DETAILS ELECTRONICALLY, PLEASE PRINT THIS FORM AND
FAX OR MAIL YOUR CREDIT CARD PAYMENT

BANKCARD

MASTERCARD

VISA

CARDHOLDER'S NAME	_________________________________________________________
CARD NUMBER	__ __ __ __/ __ __ __ __ /__ __ __ __ /__ __ __ __
EXPIRY DATE	__ __/__ __
CARDHOLDER'S SIGNATURE	_________________________________________________________

This page has been authorized by Professor Iain McCalman, Director HRC as relevant officer.
For feedback or enquiries, contact administration.hrc@anu.edu.au
Last Modified: Fri, 06 Jun 2003