I N T E R C O M
INTERNATIONAL COMMITTEE ON MANAGEMENT
COMITÉ INTERNATIONAL POUR LA GESTION
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Please fax this booking form to Conference Logistics on +61 2 6285 1336 or post to PO Box 201, DEAKIN WEST ACT 2600 AUSTRALIA by Friday 17 October 2003. For queries, please email conference@conlog.com.au
Family Name................................................ Title............................... First name...................................
Please number accommodation in order of preference: All rates are room only.
ETA.........Arrival Date: / /2003 Departure Date: / /2003
I will be sharing my room with _____________________________________________________________________
__ I agree to my credit card details being forwarded to the nominated hotel to guarantee my accommodation. (The hotel will debit the card once you check in or if you fail to arrive on the nominated check in date.)
Type of card: __ Mastercard __ Bankcard __ Visa __ AMEX __ Diner's Card
Name on the card: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Expiry date: _ _ / _ _
Credit card number: _ _ _ _ / _ _ _ _ / _ _ _ _ / _ _ _ _
Signature: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
__ I enclose bank draft for AUD $ _ _ _ _ drawn on an Australian Bank, payable to Intercom Conference 2003
__ I am faxing registration form and bank draft will follow.
All changes, amendments and cancellations need to be notified in writing to Conference Logistics. Hotels may apply a cancellation fee of the first night's deposit for cancellations received after 7 November 2003.
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